摘要
目的提高对急性髓系白血病合并B淋巴细胞增殖性疾病的认识。方法报道3例急性单核细胞白血病伴未治疗的慢性淋巴细胞白血病／单克隆B淋巴细胞增多症的临床及实验室检查的特点，并复习文献。结果3例均为60岁以上老年患者，以贫血、出血或感染起病，2例患者外周血白细胞明显增高。3例骨髓形态学、组织化学、骨髓病理等检查均支持急性单核细胞白血病诊断，经流式细胞术检查除发现异常单核细胞外，可见B淋巴细胞表型异常，为CD5（＋）、CD19（＋）、CD23（＋）、CD20（＋）、CD22（＋）、FMC7（-）。且异常B细胞占淋巴细胞比例明显增高，2例患者外周血B淋巴细胞绝对值〉5×10^9／L，考虑为急性髓系白血病合并B一慢性淋巴细胞白血病。1例患者外周血中单克隆性B淋巴细胞绝对值〈5×10^9／L，考虑为急性髓系白血病合并单克隆B淋巴细胞增多症。1例患者常规化疗缓解后复发死亡。结论急性单核细胞白血病伴未治疗的慢性淋巴细胞白血病／单克隆B淋巴细胞增多症十分少见，尤其在B淋巴细胞绝对值无明显增多的情况下容易漏诊，诊断时应结合多个实验室检查进行分析，流式细胞术检查至关重要。
Objective To identify the clinical and pathological featuers of acute myeloid leukemia with B lymphoproliferative disorders. Methods The characteristics of 3 cases of acute monocytic leukemia with untreated chronic lymphocytic leukemia/monoclonal B-cell lymphocytosis were reported with literatures review. Results The patients presented with a history of anemia, bleeding and/or fever. Acute monocytic leukemia was diagnosed by bone marrow morphology, cytochemistry and pathology studies. Immunophenotyp- ing by flow cytometry analysis showed a significant population of absolute B-lymphocyte count of 〉 5 x 109/L in a patients, similar to that of chronic lymphocytic leukemia. Conclusions The association of acute mono- cytic leukemia and untreated chronic lymphocytic leukemia/monoclonal B-cell lymphocytosis was a rare event. The abnormal B lymphocytes was likely to be misdiagnosised. Thus, it was important to combine several kinds of laboratory studies, especially flow cytometry to identify this rare disorder.
出处
《中华血液学杂志》
CAS
CSCD
北大核心
2012年第9期710-714,共5页
Chinese Journal of Hematology
