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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。 相似文献
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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 相似文献
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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。 相似文献
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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。 相似文献
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不同亚型急性髓性白血病细胞转化为树突状细胞的研究 总被引:1,自引:0,他引:1
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 相似文献
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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。 相似文献
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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. 相似文献
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SANJIV SHARMA SUNIL PURI LAXMAN DAS D. K. GUPTA V.N. BAIJAL 《Journal of Medical Imaging and Radiation Oncology》1988,32(2):207-213
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. 相似文献
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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. 相似文献
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[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。 相似文献
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Prognostic Factors and Survival in Acute Myeloid Leukemia Cases: a Report from the Northeast of Iran 下载免费PDF全文
Abolghasem AllahyariTarane TajeriMasoud Sadeghi 《Asian Pacific journal of cancer prevention》2016,17(3):1547-1551
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. 相似文献
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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. 相似文献