[9例并发吉尔伯特综合征的血液恶性肿瘤患者异基因造血细胞移植的临床分析]。

X L Zhu, J Z Wang, M Lyu, T T Han, F M Zheng, Y Y Chen, Y Y Zhang, H Chen, X H Zhang, L P Xu, X J Huang, Y Wang
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引用次数: 0

摘要

2013年1月1日至2024年3月1日,北京大学人民医院对9例吉伯特综合征并发血液恶性肿瘤患者进行了异基因造血干细胞移植(allo-HSCT)。患者中男性7例,女性2例,中位年龄38(13-60)岁。其中,3 例为急性髓细胞白血病,3 例为急性淋巴细胞白血病,2 例为骨髓增生异常综合征,1 例为慢性粒单核细胞白血病。所有患者都没有病毒性肝炎。九例患者中,七例接受了Bu-Cy+ATG方案,另外两例接受了TBI-Cy+ATG方案(Bu,丁硫璜;Cy,环磷酰胺;ATG,抗胸腺细胞免疫球蛋白;TBI,全身照射)。所有患者都获得了中性粒细胞移植,8 名患者获得了血小板移植。移植前总胆红素水平中位数为45.4(22.5-71.2)μmol/L,预处理-1d时为22.0(18.0-37.2)μmol/L。与移植前的基线水平相比,8 名患者移植后 20 天的总胆红素水平有所下降。此外,一名患者在移植后+5d总胆红素水平出现一过性升高,这被认为是Bu的毒性所致。没有患者并发肝静脉闭塞症。中位随访时间为 739(42-2 491)天。在随访期间,一名患者死于复发,其余八名患者均无病存活。
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[Clinical analysis of allogeneic hematopoietic cell transplantation in 9 patients with hematological malignancies complicated by Gilbert's syndrome].

From January 1, 2013, to March 1, 2024, nine patients with hematological malignancies complicated by Gilbert's syndrome in Peking University People's Hospital underwent allogeneic hematopoietic stem cell transplantation (allo-HSCT). The patients comprised seven male and two female cases, with a median age of 38 (13-60) years old. Among them, three cases were acute myeloid leukemia, three cases were acute lymphocytic leukemia, two cases were myelodysplastic syndrome, and one case was chronic myelomonocytic leukemia. None of the patients had viral hepatitis. Of the nine cases, seven cases received the Bu-Cy+ATG regimen, while the other two cases received the TBI-Cy+ATG regimen (Bu, busulfan; Cy, cyclophosphamide; ATG, antithymocyte immunoglobulin; and TBI, total body irradiation). All patients achieved neutrophil engraftment, and eight received platelet engraftment. The median total bilirubin level was 45.4 (22.5-71.2) μmol/L before transplantation and 22.0 (18.0-37.2) μmol/L on -1d of preconditioning. The total bilirubin level on +20d after the transplantation of eight patients decreased compared with the baseline level before transplantation. Moreover, one patient had a transient increase in the total bilirubin level on +5d after transplantation, which was considered to be attributed to the toxicity of Bu. No patients were complicated by hepatic veno-occlusive disease. The median follow-up time was 739 (42-2 491) days. During the follow-up period, one patient died of recurrence, and the remaining eight patients had disease-free survival events.

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