论文部分内容阅读
目的:探讨相关性急性髓细胞白血病(t AML)的发病机制和治疗方法。方法:分析1例t AML的临床资料、诊治过程、预后转归并复习相关文献。结果:患儿基础疾病为急性淋巴细胞白血病(ALL),使用足叶乙苷(VP-16)规范化疗方案治疗后痊愈。停止化疗1年后出现贫血、白细胞及血小板减少,骨髓检查诊断为治疗相关性骨髓增生异常综合征(t MDS)并转化为t AML。使用DAE方案治疗达到细胞学完全缓解(CR)但未能达到分子学CR。结论:(1)避免使用VP-16化疗方案可减少t AML发生;(2)t AML发病前可有t MDS过程;(3)t AML患儿对化疗常不敏感,干细胞移植可提高长期无病生存率。
Objective: To investigate the pathogenesis and treatment of related acute myeloid leukemia (t AML). Methods: One case of t AML clinical data, diagnosis and treatment process, prognosis and review the relevant literature. Results: The underlying disease in children was acute lymphoblastic leukemia (ALL), which was cured after treatment with regimen of etoposide (VP-16). Anemia, leukopenia and thrombocytopenia were observed after 1 year of chemotherapy discontinuation. Bone marrow examination was diagnosed as treatment-associated myelodysplastic syndrome (t MDS) and converted to t AML. Treatment with the DAE regimen achieved cytoreductive (CR) but failed to achieve molecular CR. Conclusions: (1) Avoid the use of VP-16 chemotherapy to reduce the incidence of t AML; (2) t MDS before t AML onset; (3) t AML children are often not sensitive to chemotherapy, stem cell transplantation can improve long-term Survival rate.