Epstein-Barr病毒阳性的移植后淋巴组织增生性疾病,移植后早期T细胞嵌合率显著下降:病例报告。

IF 1.4 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING World journal of radiology Pub Date : 2024-10-28 DOI:10.4329/wjr.v16.i10.600
Qing-Na Guo, Hai-Sheng Liu, Lin Li, Dian-Ge Jin, Ji-Min Shi, Xiao-Yu Lai, Li-Zhen Liu, Yan-Min Zhao, Jian Yu, Yan-Yuan Li, Fang-Quan Yu, Zhe Gao, Jiao Yan, He Huang, Yi Luo, Yi-Shan Ye
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引用次数: 0

摘要

背景:移植后淋巴组织增生性疾病(PTLD)是异基因造血细胞移植(allo-HCT)或实体器官移植(SOT)后发生的一种罕见但高度致命的并发症。病例摘要:我们报告了一例Epstein-Barr病毒阳性的PTLD,表现为弥漫性大B细胞淋巴瘤(DLBCL),异基因造血干细胞移植后早期T细胞嵌合率明显下降。一名30岁的急性髓性白血病患者在首次完全缓解后接受了无关的异种器官移植。移植后近3个月,患者出现颈淋巴结肿大和胃部病变,病理结果均提示为DLBCL。与此同时,患者的T细胞嵌合率持续显著下降。在接受单药利妥昔单抗化疗和随后的R-CHOP联合化疗后,患者病情得到部分缓解:结论:T细胞嵌合体的丧失和伴随的T细胞功能不全可能是该患者PTLD的病因。
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Epstein-Barr virus positive post-transplant lymphoproliferative disorder with significantly decreased T-cell chimerism early after transplantation: A case report.

Background: Post-transplant lymphoproliferative disorder (PTLD) is a rare but highly fatal complication occurring after allogeneic hematopoietic cell transplantation (allo-HCT) or solid organ transplantation (SOT). Unlike SOT, PTLD after allo-HCT usually originates from the donor and is rarely accompanied by a loss of donor chimerism.

Case summary: We report a case of Epstein-Barr virus positive PTLD manifesting as diffuse large B-cell lymphoma (DLBCL) with significantly decreased T-cell chimerism early after allo-HCT. A 30-year-old patient with acute myeloid leukemia underwent unrelated allo-HCT after first complete remission. Nearly 3 mo after transplantation, the patient developed cervical lymph node enlargement and gastric lesions, both of which were pathologically suggestive of DLBCL. Meanwhile, the patient experienced a significant and persistent decrease in T-cell chimerism. A partial remission was achieved after chemotherapy with single agent rituximab and subsequent R-CHOP combined chemotherapy.

Conclusion: The loss of T-cell chimerism and the concomitant T-cell insufficiency may be the cause of PTLD in this patient.

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来源期刊
World journal of radiology
World journal of radiology RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-
自引率
8.00%
发文量
35
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