N Engl J Med:大剂量雌激素替代疗法、利妥昔单抗和早期造血干细胞移植治疗1例沃尔曼病患儿
本文由小咖机器人翻译整理
期刊来源:N Engl J Med
原文链接:https://doi.org/10.1056/NEJMoa2313398
摘要内容如下:
沃尔曼病是一种严重的溶酶体酸性脂肪酶缺乏症,导致肝脏和肠道中的病理性脂质积聚,如果不进行治疗,在婴儿期是致命的。尽管持续的酶替代疗法(ERT)与限制脂肪饮食相结合可以延长寿命,但其治疗效果可能会随着时间的推移而减弱。异基因造血干细胞移植(HSCT)提供了一个更明确的解决方案,但有很高的死亡风险。在这里,我们描述了一名患有沃尔曼病的婴儿,他接受了高剂量的ERT,同时接受了饮食脂肪限制和基于利妥昔单抗的B细胞耗竭,作为早期造血干细胞移植的桥梁。在32个月时,婴儿不依赖于ERT且无疾病,外周血中有100%供者嵌合体。
英文原文如下:
Abstracts
Wolman's disease, a severe form of lysosomal acid lipase deficiency, leads to pathologic lipid accumulation in the liver and gut that, without treatment, is fatal in infancy. Although continued enzyme-replacement therapy (ERT) in combination with dietary fat restriction prolongs life, its therapeutic effect may wane over time. Allogeneic hematopoietic stem-cell transplantation (HSCT) offers a more definitive solution but carries a high risk of death. Here we describe an infant with Wolman's disease who received high-dose ERT, together with dietary fat restriction and rituximab-based B-cell depletion, as a bridge to early HSCT. At 32 months, the infant was independent of ERT and disease-free, with 100% donor chimerism in the peripheral blood.
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