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目的:探讨单倍体相合造血干细胞移植治疗自体移植后复发的难治性骨霍奇金淋巴瘤的可行性。方法:报道1例原发性骨霍奇金淋巴瘤患者的诊断、治疗和移植经过,结合文献复习,提高对该病的认识。结果:该患者初诊为骨结核,抗结核治疗无效,经病变局部活检最终确诊为原发骨霍奇金淋巴瘤,多个疗程化疗缓解并自体造血干细胞移植,移植后4个月复发。经多疗程含硼替佐米的联合化疗方案挽救治疗再次达完全缓解,继而行单倍体相合造血干细胞移植,植入成功,造血重建,中性粒细胞>0.5×109/L及血小板>20×109/L的平均时间分别为13d及19d,植入鉴定证实为供者型。移植后6个月PET/CT显示病灶无活动。结论:原发性骨霍奇金淋巴瘤是极少见的淋巴瘤,早期诊断困难,确诊主要临床特征、影像学及病理检查,放化疗是常规治疗手段。对难治或自体造血干细胞移植后复发年轻患者,选择含硼替佐米的联合化疗方案作为其挽救治疗,随后行单倍体相合造血干细胞移植,方法可行,国内外未见类似报道。
Objective: To investigate the feasibility of haploidentical hematopoietic stem cell transplantation in the treatment of refractory B-Hodgkin’s lymphoma recurrence after autotransplantation. Methods: The diagnosis, treatment and transplantation of one patient with primary osteoinductive lymphoma were reported. Combined with the literature review, the knowledge of the disease was improved. Results: The patient was newly diagnosed as osteoporosis. The anti-TB therapy was ineffective. Local bone biopsy finally confirmed the primary osteo-Hodgkin’s lymphoma. Multiple courses of chemotherapy were relieved and allogeneic hematopoietic stem cells were transplanted. Four months after transplantation, the disease recurred. After multiple courses of bortezomib combined with chemotherapy save the treatment once again reached complete remission, followed by haploidentical hematopoietic stem cell transplantation, successful implantation, hematopoietic reconstruction, neutrophils> 0.5 × 109 / L and platelets> 20 × The average time of 109 / L was 13d and 19d, respectively, and the identification of donor was confirmed as donor type. Six months after transplantation PET / CT showed no activity in the lesion. Conclusion: Primary osteoarthritis of the lymphoma is an uncommon lymphomas. It is difficult to diagnose early. The main clinical features, imaging and pathology are confirmed. Radiotherapy and chemotherapy are the routine treatment. For refractory or autologous hematopoietic stem cell transplantation in young patients relapsed, the choice of bortezomib combination chemotherapy as its treatment, followed by haploidentical hematopoietic stem cell transplantation, the method is feasible, no similar reports at home and abroad.