淋巴母细胞淋巴瘤并存急性髓系白血病  

T-Lymphoblastic Lymphoma Combined with Acute Myeloid Leukemia

作　　者：张宗[1] 归薇[1] 白敏[1] 马莉[1] 苏丽萍[1] 关涛[1] ZHANG Zong;GUI Wei;BAI Min;MA Li;SU Li-Ping;GUAN Tao(Department of Hemntology,The Affiliated Tumor Hospital of Shanxi Medical University,Taiyuan 030013,Shanxi Province,China)

机构地区：[1]山西医科大学附属肿瘤医院血液科,山西太原030013

出　　处：《中国实验血液学杂志》2018年第5期1378-1383,共6页Journal of Experimental Hematology

摘　　要：目的:探讨T淋巴母细胞淋巴瘤(T-LBL)并存急性髓系白血病(AML)的诊断与治疗。方法:对4例T-LBL并存AML患者的临床特征进行回顾性分析,其中例1和例2为同时发生,例3和例4为继发性。对于同时发生的患者,需鉴别AML的淋巴结浸润。结果:经多次审阅淋巴结病理形态学特点,免疫组织化学检测和T细胞受体基因重排,符合T-LBL;通过骨髓细胞形态学,细胞化学,流式细胞术免疫分型,染色体和融合基因检查,确定白血病类型为AML。流式细胞术检测发现,2例分别为双表型和双系列型的急性混合细胞白血病。4例患者均接受化疗,且均死于白血病。生存期仅为确诊AML后2-5个月。结论:T-LBL并存AML是侵袭性疾病,预后差,目前尚无标准治疗方案,因此需要设计能兼顾淋系和髓系白血病的治疗方案。Objective:To investigate the diagnosis and treatment of patients with T-lymphoblastic lymphoma(T-LBL)combined with acute myeloid leukemia(AML).Methods:The clinical features of 4 patients with T-LBL combined with AML were retrospectively analyzed,Among them the case 1 and 2 were synchronous occurrence,and case 3 and 4 were sequentially occurred.Especially for former 2 patients,the dliagnosis differentiated from the involved lymph node of AML is important.Results:The biopsies,immunohistochemical(IHC)test and T-cell receptor(TCR)gene rearrangement of the lymph node have been re-evaluated in our institulion.The diagnosis of T-LBL was confirmed.The diagnosis of AML was based on morphology,cytochemistry,immunophenotypy,karyotype and fusion gene of cells.The biphenotypic and bilineal types were found by flow cytometriy(FCM).The diagnosis of mixed acute leukemin(MAL)was confirmed.All the patients received chemotherapy,all of which died from leukemia.The survivnl duration was 2 to 5 months from the diagnosis of AML.Conclusion:T-LBL combined with AML is an aggressive disease with am unfarourable prognosis,The new therapies should be designed to treat these rare cases.

关 键 词：T淋巴母细胞淋巴瘤 急性髓细胞白血病 淋巴瘤与髓系白血病并存 

分 类 号：R733.1[医药卫生—肿瘤] R733.71[医药卫生—临床医学]