慢性粒细胞白血病向T细胞淋巴瘤/白血病急变合并肺癌一例  

A case of chronic myelogenous leukemia transforming into T cell lymphoma/leukemia complicated with lung cancer

作　　者：付佳丽 高陆 夏戌慧 任明强 FU Jia-li;GAO Lu;XIA Xu-hui;REN Ming-qiang(Department of Hematology,Affiliated Hospital of Zunyi Medical University,Zunyi 563000,Guizhou,CHINA)

机构地区：[1]遵义医科大学附属医院血液内科,贵州遵义563000

出　　处：《海南医学》2025年第5期717-720,共4页Hainan Medical Journal

基　　金：贵州省遵义市联合基金项目[编号:遵市科合HZ字(2023)299号];贵州省卫生健康委科学技术基金项目(编号:gzwkj2025-295);贵州省卫健委联合基金项目(编号:gzwkj2022-069)。

摘　　要：慢性粒细胞白血病(CML)是起源于多能造血干细胞的恶性克隆增殖性疾病,复杂核型、染色体的畸变和基因的突变是导致CML急变的主要原因;多原发癌(MPC)也称为第二原发癌,是一种罕见的致癌性现象,按照肿瘤发生的时间间隔可分为同时性多原发癌和异时性多原发癌。本病例为CML合并肺癌,根据CML与肺癌的诊断时间,考虑为同时性多原发恶性肿瘤,肺癌术后出现高热,经骨髓象、骨髓活检及免疫分型等检查考虑为慢性粒细胞白血病T淋巴瘤/白血病急变,予以CHOP方案化疗,同时积极予以抗感染等对症治疗,但患者最终因呼吸衰竭死亡。Chronic myelogenous leukemia(CML)is a malignant clonal proliferative disease originating from pluripotent hematopoietic stem cells.Complex karyotype,chromosomal aberration,and gene mutation are the main causes of CML's acute transformation.Multiple primary carcinoma(MPC)are also called second primary cancer,which is a rare carcinogenic phenomenon.According to the time interval of tumor occurrence,it can be divided into simultaneous multiple primary cancers and metachronous multiple primary cancers.This case report describes a patient with CML and concurrent lung cancer,considered synchronous MPC based on the timing of diagnoses.After lung cancer surgery,the patient developed high fever,and bone marrow morphology,biopsy,and immunophenotyping suggested a transformation of CML into T-cell lymphoma/leukemia blast crisis.The patient was treated with the CHOP chemotherapy regimen alongside aggressive anti-infective therapy but ultimately succumbed to respiratory failure.

关 键 词：慢性粒细胞白血病急变 复杂核型 肺癌 多发原癌 

分 类 号：R733.72[医药卫生—肿瘤]