CD19/CD3双抗治疗儿童B-ALL合并特鲁索综合征1例并文献复习

CD19/CD3 Dual Antibody Treatment of Chil-dren B-ALL Combined with Trousseau Syn-drome: A Case Report and Literature Review

摘要: 目的：探索应用CD19/CD3双抗治疗儿童B型急性淋巴细胞白血病(B-Acute Lymphoblastic Leukemia, B-ALL)合并特鲁索综合征，为此类患儿寻求更佳治疗手段。方法：回顾性分析1例B-ALL合并特鲁索综合征患儿的诊疗过程，并结合文献进行复习。结果：患儿，男，7岁，因“发热、血象异常”就诊，经形态学(M)、免疫学(I)、细胞遗传学(C)和分子生物学(M)，即MICM综合分型确诊为B-ALL。在诱导治疗期间微小残留(MRD)未转阴，继发特鲁索综合征，患儿短时间内无法进行强化及巩固化疗、形态学复发风险升高，而CD19/CD3双抗相对于传统强化疗，其骨髓抑制轻，不良反应少，为患儿长期缓解争取了时间。结论：对于常规化疗效果不佳或不能耐受化疗的B-ALL患儿，CD19/CD3双抗治疗可作为有效的过度治疗方案，可以为此类患儿提供新的治疗选择。

Abstract: Objective: This study aimed to explore the application of CD19/CD3 dual antibody in the treatment of children with B-Acute Lymphoblastic Leukemia (B-ALL) complicated with Trousseau syndrome, and to seek better treatment for these children. Methods: The treatment of a child with B-ALL com-bined with Trousseau’s syndrome was retrospectively analyzed and reviewed in light of the litera-ture. Results: The patient, a male, 7 years old, was diagnosed with B-ALL due to “fever and abnormal hematology” and was diagnosed as B-ALL by Morphology (M), Immunology (I), Cytogenetics (C), and Molecular biology (M), namely MICM comprehensive typing. During induction therapy, the patient was combined with Trousseau’s syndrome, and children could not receive chemotherapy such as reinforcement and consolidation within a short time, resulting in an increased risk of morphological recurrence. However, the application of CD19/CD3 dual antibody provided a distinct advantage of effectively eliminating microscopic residuals (MRD) and reducing the incidence of complications caused by chemotherapy drugs in patients. This allowed for additional time to achieve long-term remission in the child. Conclusion: CD19/CD3 dual antibody therapy can be used as an effective overtreatment for B-ALL children with poor conventional chemotherapy or who cannot tolerate chemotherapy and can provide a new treatment option for such children.