高龄老年慢性骨髓增殖性疾病转化的急性粒细胞白血病1例  

Acute myeloid leukemia transformed from chronic myeloproliferative disease： a very old case analysis

作　　者：陈雪松[1] 万文辉[1] 张兴虎[1] 翟永平[2] 施毅[3] 钱晓明[1] 齐玉琴[1] 吴宁[1] 

机构地区：[1]南京军区南京总医院干部病房一科,南京210002 [2]南京军区南京总医院血液科,南京210002 [3]南京军区南京总医院呼吸内科,南京210002

出　　处：《中华老年多器官疾病杂志》2013年第12期941-943,共3页Chinese Journal of Multiple Organ Diseases in the Elderly

摘　　要：1例慢性增殖性疾病的高龄老年患者（82岁），予羟基脲治疗，并按血小板、白细胞数调整剂量；此后转化为急性粒细胞白血病，增加羟基脲剂量的同时出现粒细胞缺乏及感染，加之患者高龄、基础疾病多，给治疗带来极大难度。经血液科、呼吸内科会诊综合调整，加强支持治疗，现患者一般情况尚可，病情相对稳定，但总体预后不佳。如何针对高龄老年血液病完善治疗，是非血液专业的老年科医师亟待加强的问题。A very old patient （82 years old） with chronic proliferative disease was treated by hydroxyurea, and its dose was adjusted according to the counts of platelets and leukocytes. Subsequently, the disease transformed into acute myeloid leukemia （AML）. When the dose of hydroxyurea is increased, agranulocytosis and infection appeared. Since the patient was very old and had a few multiple comorbid diseases, it was very difficult for his treatment. After a consultation attended by physicians from disciplines of hematology and respiratory diseases, the comprehensive adjustment was made to strengthen supporting treatment. In present, the condition of the patients is fair, and relatively stable, but the overall prognosis is poor. How to improve the treatment of hematological diseases in very old patients is the issue urgent to be solved by non-hematological geriatric physicians.

关 键 词：慢性骨髓增殖性疾病 老年人 80以上 化疗 肺部感染 耐药 

分 类 号：R592[医药卫生—老年医学] R733.71[医药卫生—内科学]