急性髓细胞性白血病微分化型1例附文献复习

急性髓细胞性白血病微分化型（AML-M0）是急性白血病的罕见类型，其临床表现、细胞形态、细胞遗传学及免疫表型、疗效和预后方面均有其特点。本文报告一例患者的诊治过程，并对有关国内外文献进行了综述。     

以附件浸润为首发的急性髓系白血病一例并文献复习

 目的　报道1例以子宫附件浸润为首发的急性髓系白血病（AML）,评价预后并进行文献复习。方法　采用MICM标准确诊。形态学包括骨髓涂片、细胞化学染色、组织活检、免疫组织化学,流式细胞术分析免疫表型和RHG显带技术进行细胞遗传学分析。结果　该例患者确诊为AML-M2型。结论　AML可能有特殊的临床表现和细胞遗传学改变。     

以纵隔占位为首发表现的急性髓系白血病一例并文献复习

目的：探讨以纵隔占位为首发表现的急性髓系白血病（AML）的临床、影像学、骨髓象特点及发病机制。方法对1例以纵隔占位为首发表现AML患者的临床资料进行回顾性分析并复习相关文献。结果患者因反复咳嗽5个月入院。5个月前因咳嗽行胸部CT扫描示前纵隔占位,行胸腔镜下纵隔病变活组织检查及免疫组织化学检查,诊断考虑前纵隔髓细胞肉瘤,骨髓涂片+骨髓流式细胞术检测符合AML。明确诊断为AML髓外浸润。结论以纵隔占位为首发症状的白血病少见,临床易误诊,应注意鉴别。治疗可选用化疗、局部放疗、造血干细胞移植等综合措施。     

心肌梗死为首发症状的急性髓系白血病1例

急性白血病起病急,病情重,发展快,病程一般在6个月内,骨髓与周围血液中以原始和早期幼稚细胞为主。临床多表现为贫血相关症状,皮肤黏膜出血,发热,骨、关节疼痛,胸骨下段压痛及白血病细胞浸润等相关组织器官症状。心肌梗死为首发症状的急性白血病较为罕见。现报告1例以心肌梗死首发的伴重现性遗传学异常的急性髓系白血病。     

低分化型急性髓细胞性白血病

1987年,Lee等首先报告了10例低分化型急性非淋巴细胞白血病(MD-ANLL),认为它们是一型独特的白血病。国内对该型白血病尚未见报告。本院对196例急性白血病(急白)细胞表面标记和常规形态学(FAB)观察过程中,发现该型白血病8例(4％),现报告如下。材料与方法一、病例 1987年6月～1991年6月来本院诊治的儿童或外院送检细胞表面标记的成人病例各4例,均为男性。形态学诊断:急性淋巴细胞白血病(ALL)L_1型2例,L_2型4例,L_3型2例。二,标本 1例(例5)在当地医院经CODP(环磷酰胺+长春新碱+柔红霉素+泼尼松)治疗1     

急性髓系白血病合并慢性淋巴细胞白血病一例报道及文献复习

 目的 探讨急性髓系白血病（AML）合并慢性淋巴细胞白血病（CLL）的临床特点、病因、诊断、治疗及预后。方法 临床诊断1例AML合并CLL,并就相关文献进行复习。结果 患者经MA方案（米托蒽醌10 mg／d第1 ~ 3天,阿糖胞苷150 mg／d第1,3,5,7天,200 mg第2,4,6天）化疗后取得完全缓解,但CD19阳性的淋巴细胞（表达CD20,CD23,SIgM,部分表达CD5,CD22,CD25）仍然存在,于9个月后AML复发未能再次缓解而死亡。结论 AML合并CLL为一种具有特殊生物学特征的罕见疾病,免疫分型和细胞遗传学技术在疾病的诊断和认识中发挥重要作用,治疗应以AML为主。     

含白消安注射液的预处理方案治疗急性髓细胞白血病二例并文献复习

 目的 评价白消安注射液（ivBu）作为急性髓细胞白血病（AML）造血干细胞移植（HSCT）预处理的疗效和安全性。方法 2例AML患者采用ivBu联合环磷酰胺（Cy）进行预处理,进行HLA相合的同胞外周血干细胞移植,观察其疗效和安全性。结果 2例患者均成功植入,没有严重毒副反应、肝窦状隙阻塞综合征（SOS）、严重急性移植物抗宿主病（GVHD）发生。结论 ivBuCy2方案作为AML预处理方案安全有效。     

以腹部肿块及腹水为首先表现的急性白血病1例附文献复习

急性白血病以贫血、发热、出血为主要特征。白血病髓外组织浸润常引起肝、脾、淋巴结及睾丸肿大,眼眶及皮肤黏膜绿色瘤(粒细胞肉瘤),以及中枢神经系统白血病等。由于对白血病髓外浸润细胞形态特征认识不足,极易出现误诊,特别是以局部肿块为首发症状的未经确诊的白血病。现报告1     

不同亚型急性髓性白血病细胞转化为树突状细胞的研究

目的 :探讨利用一定组合的细胞因子 ,将不同亚型的急性髓性白血病 (acute m yeloidleukemia,AML)细胞在体外转化为树突状细胞 (dendritic cell,DC)。方法 :8例初发 AML 患者 (其中M1 1例、M2 a3例、M32例、M4 c1例、M51例 )的骨髓单个核细胞 (BMMNC) ,在含 GM- CSF、IL- 4和TNF-α的完全培养液中培养 14天 ,通过光镜及电镜下观察细胞形态、流式细胞仪测定细胞免疫表型和 MTT法混和淋巴细胞反应来鉴定 DC。结果 :6例患者的 BMMNC培养 14天后转化为 DC。 DC的免疫表型 CD1 a、CD83、CD86 、HL A- DR较培养前明显上调 (P<0 .0 5 )。 DC对同种异体 T淋巴细胞有较强的刺激作用 ,远高于对照 (P<0 .0 5 ) ,而且随 DC数量的增加刺激 T细胞增生的活性越强。2例患者(M2 a1例 ,M31例 )的 BMMNC未转化为 DC,免疫表型分析显示 CD83及 CDla的表达较低 ,但 CD86 及HL A- DR的表达明显增高。结论 :利用一定组合的细胞因子可以将 AML细胞在体外转化为形态、表型和功能符合 DC特征的细胞。某些 AML患者的原始细胞不能转化为 DC,与其亚型无关 ,原因有待进一步探讨     

以肝损害为首发表现的急性髓系白血病一例并文献复习

目的探讨以肝损害为首发表现的急性髓系白血病(AML)的临床特点及治疗情况。方法对2019年9月7日解放军联勤保障部队第九四○医院收治的1例以肝损害为首发表现的AML患者的相关实验室检查、影像学、病理学结果及治疗情况进行回顾性分析,并复习相关文献。结果患者,女性,40岁,以肝损害为首发表现,结合各项实验室检查及骨髓穿刺检查结果诊断为AML。进行降低氨基转移酶治疗的同时积极治疗原发病,给予地西他滨+CAG方案定期化疗,1个疗程后达完全缓解,且肝功能基本恢复正常。结论 AML首发症状多样,且经常合并多系统器官损害,早期诊断、积极治疗原发病是改善患者预后的关键。     

Neurocysticercosis Coincident with Acute Myeloid Leukemia: A Case Report

We describe the unusual coincidence in a 25 year old Mexican immigrant who presented with neurocysticercosis and acute myeloid leukemia. Treatment for the acute leukemia was initiated after corticosteroids were administered to decrease cerebral edema caused by the neurocysticercosis. Complete remission of the leukemia was eventually achieved and specific antibiotic therapy for neurocysticercosis was initiated with praziquantel. We discuss our approach to the treatment of these two diseases, the complications that arose, and briefly review the literature on the current treatment of neurocysticercosis.     

双胞胎肝母细胞瘤3例报告并文献复习

  目的  分析肝母细胞瘤的家族遗传倾向, 为临床遗传咨询及早诊断、早治疗提供依据。  方法  收集中国医科大学附属盛京医院2005年6月至2011年11月间收治的3例双胞胎肝母细胞瘤患儿的资料, 结合患儿生化、影像、治疗方案、生存期、家族史及相关文献报道分析遗传相关因素。  结果  本文中3例双胞胎患儿均为单发, 无家族史, 其中1例为早产儿。3例患儿均采用手术治疗, 经病理证实为肝母细胞瘤, 术后1例患儿因失血性休克死亡, 余2例采用不同的化疗方案, 均获得完全缓解。自1969年至今, 已有8例关于兄弟姐妹同患此病的文献报道。8组文献中5组患儿家族中有肿瘤(多数为结肠癌)及家族性结肠息肉病史, 其中3组还有基因异常改变。  结论  肝母细胞瘤是一种罕见的小儿肝脏恶性肿瘤, 具有家族遗传倾向, 与结肠癌及家族性结肠息肉综合征密不可分, 在诊疗过程中, 有必要加强家属的认知, 做好预防保健, 争取早发现早诊断早治疗。      

急性髓系白血病合并寄生虫感染1例

1资料患者,女,41岁。主因"四肢乏力,食欲不振1月,加重伴皮疹20余天"于2012年8月入院。既往体健。查体:体温36.3℃,神清,全身皮肤散在红色皮疹,有融合成团,未见出血点及黄染;胸骨压痛,心、肺未见异常;腹软,全腹无压痛,肝、脾肋缘下未及,双下肢无浮肿。血常规:白细胞(WBC)16.9×109/L,血红蛋白(Hb):94g/L,血小板(Plt)37×109/L,外周血涂片:原幼细胞50%;骨髓相:增生活跃,粒系异常增生,以原始     

Intraspinal Lumbosacral Lipoma: Review of Literature and Report of Three Cases

Three cases of intraspinal lumbosacral lipoma are reported and the existing English literature is reviewed. Intraspinal lumbosacral lipoma presents a distinct clinical and radiological pat tern. It should be suspected if, in a child, a soft tissue mass in the lumbosacral region is associated with a neurological deficit in the lower limbs, unilateral talipes equinovarus or bony developmental defects of the vertebral bodies and sacrum. The presence of radio-lucency in the vertebral canal in plain films is pathognomonic of intraspinal lipoma. At myelography, the presence of a large thecal sac, a low position of the conus medullaris and demonstration of extension of the lesion outside the vertebral canal are characteristic of in traspinal lipoma. In infancy, these lesions may superficially resemble sacrococcygeal teratoma.     

23例微分化型急性髓系白血病临床分析

[目的]探讨微分化型急性髓系白血病（AML—M0）的临床和细胞核型特点，观察MAVP（米托蒽醌、阿糖胞苷、长春新碱、强的松）的疗效。[方法]形态学、直接双标免疫荧光法（FISH）、直接／间接R显带技术对23例确诊为AML—M0的患者进行形态学、免疫分型等临床和细胞染色体核型分析。23例患者均接受2个疗程以上MAVP方案的诱导缓解化疗。[结果]过氧化酶（POX）、苏丹黑（SB）染色阳性的原始细胞低于3％，免疫表型以MPO、CD13、CD33、CD，38、CD34抗原表达阳性率较高，染色体结构异常较为常见，复杂的染色体核型异常多见。正常细胞核型患者完全缓解率高于异常染色体核型患者。[结论]骨髓细胞形态学、细胞化学、免疫表型是诊断AML—M0的主要依据。染色体改变具有高度的异质性，核型异常患者预后不佳。MAVP是治疗AML—M0的有效化疗方案。     

Spontaneous Acute Tumor Lysis Syndrome in Acute Myeloid Leukemia? A Single Case Report with Discussion of the Literature

Acute tumor lysis syndrome (ATLS), a condition which results from a rapid destruction of tumor cells with massive release of cellular breakdown products, has been well described following the treatment of various malignancies. However, only a handful of cases of spontaneous ATLS have been reported in the literature. We describe the first reported case of spontaneous ATLS in acute myeloid leukemia (AML). A previously healthy 63 year old woman presented with a two month history of fatigue and a one week history of easy bruising. On admission she had oliguric acute renal failure, with marked elevation in serum uric acid and phosphate. A bone marrow biopsy showed AML M7 with fibrosis. The renal failure resolved with supportive care and institution of allopurinol therapy. Following this, AML induction chemotherapy resulted in complete remission. Her biochemical and clinical course were very similar to the classical ATLS seen in patients after chemotherapy. Therefore, this case represents a rare instance of acute renal failure from spontaneous ATLS, and in our opinion the first reported occurrence of spontaneous ATLS associated with AML.     

Prognostic Factors and Survival in Acute Myeloid Leukemia Cases: a Report from the Northeast of Iran

Background: Acute myeloid leukemia (AML) is a clonal hematopoietic disorder resulting from genetic alterations in normal hematopoietic stem cells. The aim of this study was to evaluate prognostic factors and survival of AML patients in the Northeast of Iran. Materials and Methods: This retrospective study covered 96 patients with AML referred to Emam Reza Hospital, Mashhad city, Iran, from 2009 to 2015. Age, sex, blood group, type of AML, fever, consumption of amphotericin B, cytogenetic forms and survival were analyzed. Also, WBC, hemoglobin and platelet levels were checked. Mean follow-up was 30.5 months (60.4% mortality). Survival was plotted by GraphPad Prism 5 with Log-rank test. Results: The mean age for all AML patients at diagnosis was 40.4 years (range, 17-77 years). Some 42.7% patients were aged In all patients, 76% had fever and 50% consumed amphotericin. T(15;17)(q22;q21) had the most prevalence (37.7%) compared to other forms. Out of 92 patients, O(30.4%) was the most common blood group and AML-M5 (28.3%) the most common subtype. There was a significant difference in survival based on WBC and consumption of amphotericin B (P<0.05). Conclusions: WBC level, fever and consumption of amphotericin B proved to be factors for survival of AML patients. The mean age for patients in Iran is lower than other areas in the World and also survival in this study was higher than in other studies.     

Orbital Tumour as Initial Manifestation of Acute Myeloid Leukemia: Granulocytic Sarcoma: Case Report

We report orbital involvement as an initial manifestation of acute myeloid leukemia in a 57-year-old woman. The patient presented with painful proptosis and limited ocular motility. Orbital computed tomography revealed bilateral homogeneous masses. Orbital biopsy was performed on the right side; and histopathology disclosed a myelocytic tumour. Despite treatment using irradiation and chemotherapy, the patient died eleven months after presentation. There appear to be only a few previous reports of acute myeloid leukemia cases presenting with orbital involvement, and most cases occurred in children. This very rare condition has a poor survival prognosis, even with radiation treatment and chemotherapy.