[因T型淋巴瘤复发而进行带血移植后严重的意识障碍]
Naokazu Nakamura1,2, Chisaki Mizumoto1, Akihiko Sugimoto3,4
1Department of Hematology/Oncology, Graduate School of Medicine, Kyoto University.
[Rinsho ketsueki] The Japanese journal of clinical hematology
|February 4, 2024
概括
尼拉拉宾在T-淋巴细胞白血病/淋巴瘤 (T-ALL/LBL) 中表现有前途,但可能导致严重的神经问题. 这一案例凸显了对接受尼拉拉治疗的患者进行警监测的必要性.
科学领域:
- 血液学 血液学 血液学
- 神经瘤学神经瘤学
- 药理学 药理学是指药理学的学科.
背景情况:
- 型淋巴细胞白血病/淋巴瘤 (T-ALL/LBL) 与预后不佳有关.
- 尼拉拉宾在复发性或耐火性T-ALL/LBL治疗中已证明有效.
- 神经学并发症是与内拉拉治疗相关的已知风险.
研究的目的:
- 在患有T-LBL.L.L.的患者中报告尼拉拉诱导的白脑病变.
- 强调在尼拉拉治疗期间监测神经系统不良事件的重要性.
主要方法:
- 一个50岁的男性患者的病例报告,在异构后的外周血液干细胞移植后复发的T-LBL.
- 用内拉拉单疗法治疗,随后进行带血移植.
- 临床观察,尸检结果和诊断成像审查.
主要成果:
- 患者在一轮尼拉拉治疗后实现了完全缓解.
- 在进行带血移植后,该患者出现了持续的意识障碍.
- 尸体解剖结果显示,内拉拉诱导的白脑病变是神经症状的原因.
结论:
- 尼拉拉宾治疗虽然对T-ALL/LBL有效,但存在严重神经毒性的风险.
- 密切的神经监测,包括成像和专家咨询,对于接受nelarabine的患者至关重要.
- 这一案例凸显了白细胞大脑病变作为内拉拉治疗的严重并发症的可能性.
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