摘要
目的增加对治疗相关性继发白血病的认识。方法报道非霍奇金淋巴瘤治疗后2年继发急性髓细胞白血病M6型1例,结合文献讨论治疗相关性白血病的发病机制、治疗、预后。结果 1例73岁非霍奇金淋巴瘤患者接受R(Rituxmab,利妥昔单抗)-CHOP环磷酰胺+多柔比星+长春新碱+泼尼松方案规律化学治疗。治疗结束24+个月后,经骨髓涂片及细胞免疫分型诊断为急性髓细胞白血病M6型,染色体检查为:44～48,XY,del(5)(q12q33),-8,-10,der(12)t(4;12)(q11-q12;p13),其一般情况急剧恶化并死亡。结论治疗相关性白血病的发生可能与烷化剂等化疗药物使用和免疫受损等有关,利妥昔单抗导致第二肿瘤的发生暂时不能除外。治疗相关性白血病常伴有复杂染色体核型,其病情发展迅速,治疗效果差,生存期明显缩短。
Objective To improve the understanding of secondary therapy-related leukemia.Methods The clinical data of one patient with non-Hodgkin lymphoma which transformed into acute myeloid leukemia M6 2 years after chemotherapy were studied.We discussed the pathogenesis,treatment and prognosis of therapy-related leukemia with literature review.Results A 73-year-old patient diagnosed to have non-Hodgkin’s lymphoma accepted R-CHOP chemotherapy.Two years after the treatment,the disease fi nally developed into acute myeloid leukemia M6 confi rmed by cytogenetics,bone marrow morphology and owcytometry analysis.The chromosome analysis demonstrated complex karyotypes as 44-48,XY,del（5）（q12q33）,-8,-10,der（12） t（4;12）（q11-q12;p13）.His general status deteriorated rapidly and soon after the patient died.Conclusions Occurrence of therapy-related leukemia may be due to the administration of alkylating agents,topoisomerase inhibitors and damage of immune function.Therapy-related leukemia often occurs with complex karyotypes and progresses rapidly with poor treatment response.
出处
《华西医学》
CAS
2012年第1期14-17,共4页
West China Medical Journal
