伴t(8;21)异常白血病行异基因造血干细胞移植后并发粒细胞肉瘤的临床分析  

Granulocytic sarcomas in t (8;21) acute myeloid leukemia after allogeneic stem cell transplant:a case report

作　　者：郭荣[1] 杜欣[1] 翁建宇[1] 陆泽生[1] 罗成伟[1] 吴穗晶[1] 邓程新[1] 

机构地区：[1]广东省医学科学院,广东省人民医院血液科,广州市510080

出　　处：《实用医学杂志》2009年第14期2244-2247,共4页The Journal of Practical Medicine

基　　金：广东省自然科学基金资助项目(编号:06020896);国家自然科学基金资助项目(编号:30571771)

摘　　要：目的:观察1例15岁伴有t(8;21)异常的急性髓性白血病患者骨髓移植后缓解情况。方法:患者经TA方案诱导化疗达到完全缓解,继续强化巩固治疗3个疗程后行同胞HLA相合造血干细胞移植术。结果:患者移植后7个月因左膝关节疼痛再次入院,局部髂骨活检组织病理及免疫组化证实粒细胞肉瘤的诊断。骨髓涂片及原位杂交术检测AML1/ETO基因证实骨髓仍然缓解。予以中剂量A-rac化疗后出院,在院外随访过程中死亡。结论:此为首例伴有t(8;21)异常白血病行异基因造血干细胞移植术后并发髓外粒细胞肉瘤的报道。Objective We report a 15-year-old girl with t （8;21） acute myeloid leukemia （AML） and her prognosis after bone marrow transplantation. Method She achieved complete remission after induction therapy with pirarubicin and cytarabine （TA）, then received three courses of consolidation therapy prior to matched related donor peripheral blood stem cell transplantation, and had a relapse-free survival duration. 7 months following transplantation. Result The girl was rehospitalized for pain in the left knee- joint to undergo a bone marrow biopsy of the ilium and the diagnosis of granulocytic sarcoma （GS） was confirmed pathologically and immunohistochemically. Bone marrow smears and in situ hybridization for detecting AML1-ETO showed no evidence of AML relapse. She received chemotherapy with cytarabine at a moderate dose for GS, yet died during the follow-up. Conclusion To our knowledge, this is the first case of extramedullary GS in t（8;21 ） AML after allogeneic hematopoietic stem cell transplant.

关 键 词：粒细胞肉瘤 异基因造血干细胞移植 临床分析 患者 

分 类 号：R733[医药卫生—肿瘤]