急性白血病移植术后子宫及卵巢复发1例

臧慧; 付华; 雷洁钰; 易水晶

doi:10.11817/j.issn.1672-7347.2025.250057

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更新时间：2025-11-03

急性白血病移植术后子宫及卵巢复发1例
Uterine and ovarian recurrence after acute leukemia transplantation: A case report
中南大学学报(医学版) 中南大学学报(医学版) 2025年页码：1-7
作者机构：

1.中南大学湘雅三医院妇科，长沙410013
2.中南大学湘雅三医院病理科，长沙410013
作者简介：

臧慧，Email: 1379232621@qq.com, ORCID: 0009-0007-6634-0816
易水晶，Email: 7648218@qq.com, ORCID: 0000-0003-0038-8888
基金信息：
DOI：10.11817/j.issn.1672-7347.2025.250057
中图分类号：
CSTR：
收稿：2025-02-18，

网络出版：2025-11-03，
稿件说明：

臧慧, 付华, 雷洁钰, 易水晶. 急性白血病移植术后子宫及卵巢复发1例[J]. 中南大学学报(医学版), XXXX, XX(XX): 1-7.

ZANG Hui, FU Hua, LEI Jieyu, YI Shuijing. Uterine and ovarian recurrence after acute leukemia transplantation: A case report[J]. Journal of Central South University. Medical Science, XXXX, XX(XX): 1-7.
臧慧, 付华, 雷洁钰, 易水晶. 急性白血病移植术后子宫及卵巢复发1例[J]. 中南大学学报(医学版), XXXX, XX(XX): 1-7. DOI：10.11817/j.issn.1672-7347.2025.250057

ZANG Hui, FU Hua, LEI Jieyu, YI Shuijing. Uterine and ovarian recurrence after acute leukemia transplantation: A case report[J]. Journal of Central South University. Medical Science, XXXX, XX(XX): 1-7. DOI：10.11817/j.issn.1672-7347.2025.250057

摘要

急性淋巴细胞白血病(acute lymphoblastic leukemia，ALL)是常见的急性白血病，是一种造血干细胞的恶性增殖性疾病。其治疗通常采取高剂量化疗，异基因造血干细胞移植(allogeneic hematopoietic stem cell transplantation therapy，allo-HSCT)的广泛应用显著提高了白血病患者的生存率，被认为是治疗ALL的最有效方法。白血病移植术后仍存在复发的情况，主要为髓内复发，髓外复发较为少见，而髓外复发于女性生殖系统更为罕见。该研究报道1例在同种异体造血干细胞移植后出现子宫及卵巢复发的白血病。予以盆腔包块穿刺活检后诊断为白血病髓外复发。予以化疗、放疗、嵌合抗原受体T细胞免疫疗法(chimeric antigen receptor T-cell immunotherapy，CAR-T)后，子宫及卵巢肿物消失，临床治愈。急性白血病移植术后生殖系统复发易误诊为原发于生殖系统的恶性肿瘤，正确鉴别生殖系统原发肿瘤与继发肿瘤，尽早获得有效治疗极为关键。应结合临床病史及MRI影像学特点，提高诊断的正确率，以避免不必要的手术，改善患者的预后。

Abstract

Acute lymphoblastic leukemia (ALL) is a common type of acute leukemia and a malignant proliferative disease of hematopoietic stem cells. Its treatment usually adopts high-dose chemotherapy. The wide application of allogeneic hematopoietic stem cell transplantation therapy (allo-HSCT) has significantly improved the survival rate of leukemia patients. It is regarded as the most effective method for treating ALL. Recurrence still exists after leukemia transplantation

mainly intramedullary recurrence

extramedullary recurrence is relatively rare

and extramedullary recurrence in the female reproductive system is even rarer. This study reports a case of leukemia that recurred in the uterus and ovaries after allogeneic hematopoietic stem cell transplantation. After biopsy of the pelvic mass

it was diagnosed as extramedullary recurrence of leukemia. After chemotherapy

radiotherapy and chimeric antigen receptor T-cell immunotherapy(CAR-T)

the uterine and ovarian masses disappeared and the clinical cure was achieved. After acute leukemia transplantation

the recurrence of the reproductive system is prone to be misdiagnosed as a malignant tumor originating from the reproductive system. It is extremely crucial to correctly distinguish the primary and secondary tumors of the reproductive system and obtain effective treatment as soon as possible. The accuracy of diagnosis should be improved by combining the clinical history and the characteristics of MRI imaging to avoid unnecessary surgeries and improve the prognosis of patients.

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references

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