作者报告1例白血病前期、淋巴细胞增殖性疾患和浆细胞疾患并发的病人,并证实三者起源于不同的细胞克隆。患者女性,79岁,从未接受过化疗或放疗。体检见散在性瘀斑,脾及淋巴结肿大。外周血白细胞计数17,400,中性粒30％,淋巴65％。血红蛋白10.8g,MCV103。血小板15.7万。外周血涂片巨核细胞多见,形状不一的红细胞中度增多,有极少数有核红细胞及许多巨大血小板,偶见退化细胞、原始粒细胞。淋巴细胞中有些为不典型未成熟者,但大部分似已成熟。骨髓 The authors report 1 patient with pre-leukemia, lymphoproliferative disorders and plasma cell disorders, and confirmed that the three originated in different cell clones. Patient Female, 79 years old, never received chemotherapy or radiotherapy. Physical examination see scattered ecchymosis, spleen and lymph nodes. Peripheral blood leucocyte count 17,400, 30% neutral, lymph 65%. Hemoglobin 10.8g, MCV103. 157,000 platelets. Peripheral blood smear more common megakaryocytes, moderately increased red blood cells of different shapes, there are a very few nucleated erythrocytes and many huge platelets, occasionally degenerative cells, primitive granulocytes. Some of the lymphocytes are atypical immature, but most seem to be mature. marrow