治疗相关性急性髓细胞白血病1例报道并文献复习  

Therapy-Related Acute Myeloid Leukemia: One Case Report and Literature Review

作　　者：赵利师 肖剑文[1] 宪莹[1] 

机构地区：[1]重庆医科大学附属儿童医院,重庆400014

出　　处：《儿科药学杂志》2015年第10期21-23,共3页Journal of Pediatric Pharmacy

摘　　要：目的:探讨相关性急性髓细胞白血病(t AML)的发病机制和治疗方法。方法:分析1例t AML的临床资料、诊治过程、预后转归并复习相关文献。结果:患儿基础疾病为急性淋巴细胞白血病(ALL),使用足叶乙苷(VP-16)规范化疗方案治疗后痊愈。停止化疗1年后出现贫血、白细胞及血小板减少,骨髓检查诊断为治疗相关性骨髓增生异常综合征(t MDS)并转化为t AML。使用DAE方案治疗达到细胞学完全缓解(CR)但未能达到分子学CR。结论:(1)避免使用VP-16化疗方案可减少t AML发生;(2)t AML发病前可有t MDS过程;(3)t AML患儿对化疗常不敏感,干细胞移植可提高长期无病生存率。Objective： To explore the pathogenesis and treatment of therapy-related acute myeloid leukemia（ t AML）. Methods： The clinical data,treatment of 1 case with t AML were analyzed and literatures were reviewed. Results： The children was diagnosed with acute lymphoblastic leukemia（ ALL） and cured with chemotherapy contained etopside（ VP-16）. The children presented with anemia,leukocyte and platelet reduced a year after stopping chemotherapy,diagnosed with t MDS and transformed into t AML. She got cytology completely remission（ CR） instead of molecules CR. Conclusion： Morbidity of t AML decrease when patients avoid using chemotherapy contained VP-16,t MDS is in advance of t AML. Patients with t AML are not sensitive to chemotherapy,the long-term disease-free survival of t AML may improve by stem cell transplantation.

关 键 词：治疗相关性急性髓细胞白血病 足叶乙苷 化疗 

分 类 号：R725.5[医药卫生—儿科]