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目的:总结2例伴MLL重排成人急性髓系白血病(AML)异基因造血干细胞移植(allo-HSCT)后复发的治疗策略。方法:报道2例伴MLL重排AML患者行allo-HSCT后复发的诊治经过、预后,并复习有关文献。结果:病例1在化疗达再次完全缓解后行同胞半相合二次移植、供体淋巴细胞输注(DLI)联合干扰素α治疗现已无白血病生存12个月;病例2给予阿扎胞苷挽救性化疗联合粒细胞集落刺激因子(G-CSF)动员的供体外周血干细胞输注治疗后白血病获得完全缓解,但患者2个月后死于肠道移植物抗宿主病和肺部感染。结论:allo-HSCT后复发的伴MLL重排成人AML预后甚差,若有条件行DLI联合细胞因子过继免疫治疗、挽救性化疗联合G-CSF动员的供体外周血干细胞输注或二次移植,可望改善其预后。
Objective: To summarize the treatment strategies of relapse after 2 cases of allo-HSCT with MLL rearrangement adult acute myeloid leukemia (AML). Methods: Two cases of AML with MLL rearrangement were retrospectively reviewed and reviewed after allo-HSCT. Results: Case 1 was completely reopened after chemotherapy and siblings were semi-combined with secondary transplantation. Donor lymphocyte infusion (DLI) combined with interferon alpha treatment was now available for 12 months without leukemia. Case 2 was given azacitidine rescue Leukemia was completely relieved after chemotherapy-assisted granulocyte colony-stimulating factor (G-CSF) mobilization of donor peripheral blood stem cell infusion, but the patient died of g FGF and pulmonary infection after 2 months. CONCLUSIONS: Allo-HSCT with relapsed MLL rearrangement adult AML prognosis is very poor, if conditional DLI combined with cytokine adoptive immunotherapy, salvage chemotherapy and G-CSF mobilization of donor peripheral blood stem cell infusion or secondary transplant , Is expected to improve its prognosis.