浆细胞白血病的临床特征及预后分析  

Clinical features and prognosis of plasma cell leukemia

作　　者：王晶淼 樊文娟[1] 徐婷婷 付国美 姜中兴[1] Wang Jingmiao;Fan Wenjuan;Xu Tingting;Fu Guomei;Jiang Zhongxing(Department of Hematology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 460000,China)

机构地区：[1]郑州大学第一附属医院血液内科,460000

出　　处：《中国实用医刊》2020年第8期27-31,共5页Chinese Journal of Practical Medicine

摘　　要：目的探讨浆细胞白血病的临床特征及预后。方法回顾性分析2013年9月至2018年12月郑州大学第一附属医院收治的15例浆细胞白血病患者的临床资料,男11例,女4例,分析其临床表现、实验室相关指标及预后情况。结果15例患者初诊症状中腰痛或骨痛6例。外周血中白细胞增高10例,减少1例,正常4例;贫血15例;血小板减少12例,正常3例。免疫球蛋白分型以IgG型最多。β2-微球蛋白升高13例,有10例患者行荧光原位杂交检测,其中8例患者为复杂核型,2例患者为t(11;14)缺失。12例患者接受化疗,1例患者接受化疗完全缓解后行嵌合抗原受体T细胞治疗,总体缓解比例为7/15。结论浆细胞白血病是一种罕见的恶性浆细胞疾病,进展快,预后差,应从有效的含蛋白酶体抑制剂的治疗方案迅速开始治疗,然后进行大剂量化疗和自体干细胞移植。Objective To investigate the clinical features and prognosis of plasma cell leukemia.Methods The clinical data of 15 patients with plasma cell leukemia admitted in the First Affiliated Hospital of Zhengzhou University from September 2013 to December 2018 were retrospectively analyzed,among them 11 were males and 4 were females.The clinical manifestations,laboratory related indicators and prognosis of the patients were analyzed.Results Of the 15 patients,6 patients had low back pain or bone pain.Leukocytes in peripheral blood increased in 10 cases,decreased in 1 case,normal in 4 cases;anemia in 15 cases;thrombocytopenia in 12 cases,and normal in 3 cases.The most common type of immunoglobulin was IgG.Theβ2 microglobulin increased in 13 cases,fluorescence in-situ hybridization was detected in 10 patients,8 patients had complex karyotype,and 2 patients had t(11;14)deletion.Twelve patients received chemotherapy.One patient underwent CRA-T treatment after a complete response to chemotherapy.The overall response ratio was 7/15.Conclusions Plasma cell leukemia is a rare malignant plasma cell disease with rapid progress and poor prognosis.Treatment should be started quickly with effective proteasome inhibitor-containing treatment regimens,follow by high-dose chemotherapy and autologous stem cell transplantation.

关 键 词：浆细胞白血病 骨痛 贫血 

分 类 号：R733[医药卫生—肿瘤]