慢性粒细胞白血病合并宫颈腺癌1例并文献复习  

Coexistence of chronic myeloid leukemia and cervical adenocarcinoma:a rare case report and leterature review

作　　者：方慧子 陶千山 张家奎 李陈芃 李迎伟 阮燕洁 翟志敏 FANG Huizi;TAO Qianshan;ZHANG Jiakui;LI Chenpeng;LI Yingwei;RUAN Yanjie;ZHAI Zhimin(The Hematology Department and Bio?medical Research Center of Second Affiliated Hospital,Hematologic Diseases Research Center,Anhui Medical University,Hefei,Anhui 230601,China)

机构地区：[1]安徽医科大学第二附属医院血液科、生物医疗研究中心、安徽医科大学血液病研究中心,安徽合肥230601

出　　处：《安徽医药》2019年第9期1855-1858,共4页Anhui Medical and Pharmaceutical Journal

摘　　要：目的探讨慢性粒细胞白血病(CML)合并第二实体瘤病人的治疗方案和时机的选择。方法系统分析1例CML合并宫颈腺癌病人的临床资料,并查阅参考相关文献。结果对该病人初诊时CML(慢性期)予以伊马替尼治疗、手术联合化疗治疗宫颈腺癌,手术前后停用伊马替尼,术后4个月CML进展为急性淋巴细胞白血病(简称:急淋变),予以达沙替尼50 mg,每天2次,治疗1个月,获得主要分子学反应。结论(1)CML合并第二实体瘤治疗时应权衡利弊,优先治疗危险度更高的疾病;(2)CML合并第二实体瘤治疗过程中,重点监测血象及骨髓象,评估病情,当CML出现疾病进展时,及时应用第二代酪氨酸激酶抑制剂;(3)CML合并宫颈腺癌的发生机制、以及宫颈腺癌是否影响CML进展尚不明确,有待进一步研究阐明。Objective To explore the treatment solution and timing of chronic myeloid leukemia(CML)with secondary solid tumor.Methods Analyze clinical data of one case of CML with cervical adenocarcinoma,and review the relevant literatures.Results Treat chronic phase?chronic myeloid leukemia(CP?CML)with Imatinib,and treat cervical adenocarcinoma with the operation and chemotherapy.Stop Imatinib treatment before and after the operation.The progression from CP?CML to acute lymphoblastic leukemia occurred 4 months after operation,and we have treated the patient with Dasatinib50 mg twice a day for one month,and later the pa?tient obtained complete hematologic response.Conclusion(1)It is prior for coexistence of chronic myeloid leukemia and solid tu?mor to treat the disease of higher risk by weighing the pros and cons.(2)During treatment process,it is pivotal to monitor blood pic?ture and bone marrow and assess the condition.When the CML disease progress,application of the second generation of tyrosine ki?nase inhibitors is necessary.(3)It remains unclear for the mechanism of coexistence of chronic myeloid leukemia and cervical ade?nocarcinoma and whether cervical adenocarcinoma can affet progression of CML,so we need further research to clarify them.

关 键 词：白血病 髓系 慢性 BCR-ABL阳性 宫颈癌 伊马替尼 达沙替尼 

分 类 号：R73[医药卫生—肿瘤]