继发于乳腺癌的治疗相关性伴t(9;11)(p22;q23);(MLLT3-MLL)急性单核细胞白血病1例并文献复习  

A case of the t(9;11)(p22;q23);(MLLT3-MLL) breast cancer treatment-related acute monocytic leukemia and literature review

作　　者：李叶琼 包慎[1,2] 冶秀鹏[1,2] 魏玉萍[1,2] 丁建华[1,2] 

机构地区：[1]宁夏人民医院,银川750002 [2]西北民族大学第一临床学院

出　　处：《临床血液学杂志》2016年第2期243-245,共3页Journal of Clinical Hematology

基　　金：宁夏自治区对外科技合作项目资助(No:宁科技字201420);宁夏自然科学基金项目资助(No:NZ14182)

摘　　要：混合谱系白血病（mixed lineage leukemia,MLL）基因位于染色体11q23。MLL基因重排急性白血病具有不同于其他亚型白血病的特征,因此WHO提出将其单列为11q23/MLL白血病〔1〕。t（9;11）（p22;q23）;（MLLT3-MLL）易位主要发生在急性髓细胞白血病（AML）中,是AML中t（11q23）最常见的易位形式。MLL基因的变异与形态学相关最常见的类型为AML-M5和AMLM4,而MLLT3-MLL融合基因最常见于AMLM5。To explore clinical features,diagnosis and treatment of solid tumor treatment-related acute monocytic leukemia（M_5）with 11q23,we analyzed a case of the breast cancer treatment-related M_5 with t（9;11）（p22;q23）;（MLLT3-MLL）,and carried on the literature review.The patient was treated with 6cycles of chemotherapy of TEC regimens one year ago.She was admitted with acute leukemia,the myeloproliferation was extremely active,with immature monocytes and mature monocytes accounting for 62% and 31%,respectively.Karyotype analysis was 46,XX,t（9;11）（p22;q23）[20],and MLLT3-MLL was positive.According to classification rules of WHO2008 hematopoietic system disease,she was diagnosed as AML with t（9;11）（p22;q23）abnormality.Because of the patient with a preliminary history of breast cancer chemotherapy,11q23 MLL gene rearrangement could be found in a shorter incubation period of treatment-related leukemia,so the patient was diagnosed as treatment-related M_5 with 11q23/MLL.The breast cancer treatment-related M_5 with t（9;11）（p22;q23）;（MLLT3-MLL）is clinically rare,11q23 MLL gene rearrangement suggest that patients belong to a shorter incubation period of treatment-related leukemia,the prognosis is poor.We should strengthen the understanding of this disease.

关 键 词：乳腺癌 治疗相关性白血病 急性单核细胞白血病 t(9 11)(p22 q23)急性髓细胞白血病 MLLT3-MLL融合基因 

分 类 号：R733.71[医药卫生—肿瘤]