Вопросы гематологии/онкологии и иммунопатологии в педиатрии. 2024; 23: 164-168
Повторная аллогенная трансплантация гемопоэтических стволовых клеток в качестве «терапии спасения» у пациента с сепсисом и тяжелой гипофункцией гемопоэза после противоопухолевой химиотерапии
https://doi.org/10.24287/1726-1708-2024-23-3-164-168Аннотация
Проведение аллогенной трансплантации гемопоэтических стволовых клеток у пациентов с тяжелыми инфекционными процессами сопряжено с высокой смертностью на фоне прогрессии инфекции и недостаточности трансплантата. В данной статье представлен опыт успешной терапии по восстановлению кроветворения аллогенными гемопоэтическими стволовыми клетками у пациента с B-линейным острым лимфобластным лейкозом, находящегося в состоянии длительной химиоиндуцированной миелосупрессии, рефрактерной к терапии колониестимулирующим фактором, осложнившейся тяжелым септическим процессом. Благодаря восстановлению кроветворной функции инфекционный процесс был санирован и пациент смог продолжить лечение. Родители пациента дали согласие на использование информации, в том числе фотографий ребенка, в научных исследованиях и публикациях.
Список литературы
1. Mehta R.S., Rezvani K. Immune reconstitution post allogeneic transplant and the impact of immune recovery on the risk of infection. Virulence 2016; 7 (8): 901–16. DOI: 10.1080/21505594.2016.1208866
2. Zajac-Spychala O., Kampmeier S., Lehrnbecher T., Groll A.H. Infectious Complications in Paediatric Haematopoetic Cell Transplantation for Acute Lymphoblastic Leukemia: Current Status. Front Pediatr 2022; 9: 782530. DOI: 10.3389/fped.2021.782530
3. Verneris M.R., Eapen M., Duerst R., Carpenter P.A., Burke M.J., Afanasyev B.V., et al. Reduced-intensity conditioning regimens for allogeneic transplantation in children with acute lymphoblastic leukemia. Biol Blood Marrow Transplant 2010; 16 (9): 1237–44. DOI: 10.1016/j.bbmt.2010.03.009
4. Zhang H., Rodriguez S., Wang L., Wang S., Serezani H., Kapur R., et al. Sepsis Induces Hematopoietic Stem Cell Exhaustion and Myelosuppression through Distinct Contributions of TRIF and MYD88. Stem Cell Reports 2016; 6 (6): 940–56. DOI: 10.1016/j.stemcr.2016.05.002
5. Rodriguez S., Chora A., Goumnerov B., Mumaw C., Scott Goebel W., Fernandez L., et al. Dysfunctional expansion of hematopoietic stem cells and block of myeloid differentiation in lethal sepsis. Blood 2009; 114 (19): 4064–76. DOI: 10.1182/blood-2009-04-214916
6. Buxbaum N.P., Pavletic S.Z. Autoimmunity Following Allogeneic Hematopoietic Stem Cell Transplantation. Front Immunol 2020; 11: 2017. DOI: 10.3389/fimmu.2020.02017
7. Szanto C.L., Langenhorst J., de Koning C., Nierkens S., Bierings M., Huitema A.D.R., et al. Predictors for Autoimmune Cytopenias after Allogeneic Hematopoietic Cell Transplantation in Children. Biol Blood Marrow Transplant 2020; 26 (1): 114–22. DOI: 10.1016/j.bbmt.2019.07.022
8. Ngwube A., Rangarajan H., Shah N. Role of abatacept in the prevention of graft-versus-host disease: current perspectives. Ther Adv Hematol 20231 4: 20406207231152644. DOI: 10.1177/20406207231152644
9. Kruizinga M.D., van Tol M.J.D., Bekker V., Netelenbos T., Smiers F.J., Bresters D., et al. Risk Factors, Treatment, and Immune Dysregulation in Autoimmune Cytopenia after Allogeneic Hematopoietic Stem Cell Transplantation in Pediatric Patients. Biol Blood Marrow Transplant 2018; 24 (4): 772–8. DOI: 10.1016/j.bbmt.2017.12.782
Pediatric Hematology/Oncology and Immunopathology. 2024; 23: 164-168
Second allogeneic hematopoietic stem cell transplantation as salvage therapy in a patient with sepsis and severe hypofunction of hematopoiesis after chemotherapy
https://doi.org/10.24287/1726-1708-2024-23-3-164-168Abstract
When performed in patients with severe infection, allogeneic hematopoietic stem cell transplantation is associated with high mortality rates due to the progression of infection and graft failure. Here, we report a case of a successful allogeneic hematopoietic stem cell transplantation performed in a pediatric patient with B-cell acute lymphoblastic leukemia who developed persistent granulocyte colony-stimulating factor refractory chemotherapy-induced myelosuppression and severe sepsis. Following the procedure, the patient achieved hematopoietic recovery with subsequent resolution of the infection and was able to resume treatment. The patient's parents gave consent to the use of their child's data, including photographs, for research purposes and in publications.
References
1. Mehta R.S., Rezvani K. Immune reconstitution post allogeneic transplant and the impact of immune recovery on the risk of infection. Virulence 2016; 7 (8): 901–16. DOI: 10.1080/21505594.2016.1208866
2. Zajac-Spychala O., Kampmeier S., Lehrnbecher T., Groll A.H. Infectious Complications in Paediatric Haematopoetic Cell Transplantation for Acute Lymphoblastic Leukemia: Current Status. Front Pediatr 2022; 9: 782530. DOI: 10.3389/fped.2021.782530
3. Verneris M.R., Eapen M., Duerst R., Carpenter P.A., Burke M.J., Afanasyev B.V., et al. Reduced-intensity conditioning regimens for allogeneic transplantation in children with acute lymphoblastic leukemia. Biol Blood Marrow Transplant 2010; 16 (9): 1237–44. DOI: 10.1016/j.bbmt.2010.03.009
4. Zhang H., Rodriguez S., Wang L., Wang S., Serezani H., Kapur R., et al. Sepsis Induces Hematopoietic Stem Cell Exhaustion and Myelosuppression through Distinct Contributions of TRIF and MYD88. Stem Cell Reports 2016; 6 (6): 940–56. DOI: 10.1016/j.stemcr.2016.05.002
5. Rodriguez S., Chora A., Goumnerov B., Mumaw C., Scott Goebel W., Fernandez L., et al. Dysfunctional expansion of hematopoietic stem cells and block of myeloid differentiation in lethal sepsis. Blood 2009; 114 (19): 4064–76. DOI: 10.1182/blood-2009-04-214916
6. Buxbaum N.P., Pavletic S.Z. Autoimmunity Following Allogeneic Hematopoietic Stem Cell Transplantation. Front Immunol 2020; 11: 2017. DOI: 10.3389/fimmu.2020.02017
7. Szanto C.L., Langenhorst J., de Koning C., Nierkens S., Bierings M., Huitema A.D.R., et al. Predictors for Autoimmune Cytopenias after Allogeneic Hematopoietic Cell Transplantation in Children. Biol Blood Marrow Transplant 2020; 26 (1): 114–22. DOI: 10.1016/j.bbmt.2019.07.022
8. Ngwube A., Rangarajan H., Shah N. Role of abatacept in the prevention of graft-versus-host disease: current perspectives. Ther Adv Hematol 20231 4: 20406207231152644. DOI: 10.1177/20406207231152644
9. Kruizinga M.D., van Tol M.J.D., Bekker V., Netelenbos T., Smiers F.J., Bresters D., et al. Risk Factors, Treatment, and Immune Dysregulation in Autoimmune Cytopenia after Allogeneic Hematopoietic Stem Cell Transplantation in Pediatric Patients. Biol Blood Marrow Transplant 2018; 24 (4): 772–8. DOI: 10.1016/j.bbmt.2017.12.782
