慢性粒细胞白血病胫骨粒细胞肉瘤1例

慢性粒细胞白血病(CML)是伴有获得性染色异常的多能干细胞水平上的恶性变而引起的一种细胞株病,本文对1例CML胫骨粒细胞肉瘤进行分析,报道如下.     

急性髓细胞白血病转化为慢性粒细胞白血病1例

<正>慢性粒细胞白血病(CML)发病率相对较高,对治疗药物产生耐药性后易进展为急性白血病,其主要为急性髓细胞变,偶见急淋或急性双系列变[1-6]。由急性髓细胞白血病(AML)转化为CML的相关报道在国内外罕见。我院发现的1例AML转化为CML,报道如下。1病历资料患者,男,37岁。2005年于我院确诊为伴成熟型急性髓细胞白血病(AML-M2),染色体核型分析未见明显异常。治     

慢性中性粒细胞白血病1例报告

慢性中性粒细胞白血病（chronie neu uophilie leukemia,CNL）是一种少见的慢性骨髓增殖性疾病[1],临床特征为外周血成熟的中性粒细胞持续性增加,常伴脾脏肿大,老年人多见。1920年Tuohy首先对该病进行了描述,到2010年止,国内外病例报道约150例[2],内容均为临床资料、治疗及其他方向研究,无慢性中性粒细胞白血病血常规动态观察报道。江西省人民医院2014年4月17日收治1例CNL患者,笔者现对其临床资料及6个月的血常规动态观察结果进行回顾性分析,报告如下。     

慢性中性粒细胞白血病1例

患者 ,男性 ,87岁 ,因乏力、消瘦 1年半 ,加重伴右上腹不适 2个月 ,体检时发现白细胞增多入院。 1年半前曾于外院诊断再障 ,未经特殊治疗后好转。乙型肝炎病史 4 0年。查体 :全身浅表淋巴结未触及肿大 ,心肺 (— ) ,肝肋下未触及 ,脾大 ,肋下 4cm。血常规 :WBC4 8.6× 10 9/L ,分叶核 96 % ,中粒 1% ,淋巴 3% ,Hb12 4g/L ,Plt5 6× 10 9/L。URIC6 4 2 .8μmol/L(90～ 4 2 0 ) ,NAP积分 382分。骨髓象 :骨髓增生活跃 ,粒 /红=2 0 / 1,粒系明显增生 ,占 91% ,其中分叶核增多 ,呈核右移 ,部分细胞颗粒增多 ,或有少数中毒颗粒 ;红系增生…     

妊娠合并慢性粒细胞性白血病1例护理

慢性粒细胞性白血病是造血系统的一种恶性疾病,由于白血病细胞对性腺和生殖系统的浸润,使得白血病患者的受孕率低,即使受孕能维持到足月产也很罕见。我科于2007年3月4日收治了1例妊娠合并慢性粒细胞性白血病的患者,经过治疗和护理,顺利剖宫产下一活婴,现将护理措施报道如下。     

慢性粒细胞性白血病合并中枢神经系统白血病二例

【例1】 男,38岁。因间歇性头晕、头痛伴上腹部胀痛半年,加重2个月入院。查体:无皮下出血点,浅表淋巴结未触及,胸骨中段压痛,心肺未见异常,上腹部压痛,无反跳痛,脾左肋下1cm。实验室检查:血白细胞70.3×10~9/L,血红蛋白134g/L,血小板208×10~9/L,中性早幼粒细胞0.02,中性中幼粒细胞0.02,     

慢性粒细胞白血病继发肺癌1例

患者女，50岁。因上腹部钝痛、低热、恶心、呕吐，于1995年1月26日入院。入院前3个月曾出现上腹部胀满不适，时有钝痛，食欲不振，消化不佳。近1个月来上述症状加重，并出现低热、恶心、呕吐。查体：T37．2℃，P88次／min，R20次／min，BP105／75mmHg(1mmHg=0．133kPa)，周身未见出血点，浅表淋巴结无肿大，胸骨压痛( )，心肺正常，腹部     

脾脏不大的慢性粒细胞白血病1例报道

最近本院收治1例脾脏不大的慢性粒细胞白血病患者,现报道如下.1 临床资料患者,男,55岁,因乏力3月于2011年5月24日入院.查体:体温36 ℃,脉搏74次/分,血压130/80 mm Hg,呼吸16次/分,心、肺、腹阴性.腹部彩超显示:肝、胆、胰、脾、肾未见异常.入院血常规:白细胞(WBC)85.43×109/L,红细胞(RBC)5.1×1012/L,血红蛋白(Hb)153 g/L,血小板(PLT)1 062×109/L.血涂片:(1)WBC数量明显增多,以中幼、晚幼、杆状和分叶粒细胞增生为主,占82%,嗜酸性粒细胞和嗜碱性粒细胞易见,各占5%和6%.(2)血小板呈大堆易见,形态未见异常.(3)成熟红细胞形态大小大致正常.     

不典型慢性中性粒细胞白血病1例

１病例摘要 患者,男,６５岁,工人。因间断咳嗽、咳痰、多汗、消瘦１年,双足肿痛１月就诊。查体：一般情况可,右足内踝及左足背肿痛,肝肋下２ｃｍ,无压痛,脾明显增大,甲两线上７．５ｃｍ,质中、光滑、无压痛。 血常规：白细胞３３．５×ｌ０９／Ｌ,血红蛋白１１７ｇ／Ｌ,血小板６４×ｌ０９／Ｌ,末梢血涂片分类：原始粒细胞０．０１,早幼粒细胞０．０２,中性中幼粒细胞０．０１,中性晚幼粒细胞０．０１,中性杆状核粒细胞０．０５,中性分叶核粒细胞０．７３,嗜酸性分叶核粒细胞０．０１,淋巴细胞０．０８,单核细胞０．０…     

慢性嗜酸性粒细胞白血病1例并文献分析

目的:介绍和分析1例慢性嗜酸性粒细胞白血病,从而分析总结该病的临床特点.方法:回顾性分析1例慢性嗜酸性粒细胞白血病患者的临床资料.结果:本病临床特点主要为贫血以及嗜酸细胞破坏后释放出大量细胞因子引起全身各脏器损害的相关症状,细胞遗传学改变为血小板衍生的生长因子受体基因(FIPlLl/PDGFRa)阳性,预后不佳,患者放弃治疗.结论:嗜酸性粒细胞白血病的临床特点除有白血病表现外,主要为嗜酸细胞浸润各脏器,遗传学上有嗜酸性粒细胞克隆性增殖的表现.     

Synchronous gastric cancer complicated with chronic myeloid leukemia (multiple primary cancers): A case report

BACKGROUNDWith the advancement of medical technology and improvement in living standards, the incidence of multiple primary cancers has gradually increased. In particular, tumors of the digestive system account for a large proportion of multiple primary cancers. The diagnosis and treatment of chronic myeloid leukemia, particularly with synchronous gastric cancer, at the first consultation is relatively rare.CASE SUMMARYHerein, we present the case of a middle-aged man who was referred to the Department of Hematology owing to an elevated white blood cell count. After the examination, he was diagnosed with chronic myeloid leukemia and was administered imatinib. Three months after the initial diagnosis, he visited our hospital again for abdominal pain, and further examination revealed gastric malignancy. After discussion with a multidisciplinary team, S-1 (Tegafur, Gimeracil, and Oteracil Potassium Capsules) combined with oxaliplatin—SOX regimen—was initiated. Later, the patient’s condition rapidly progressed. He developed colonic obstruction and underwent an ostomy; however, he died less than 6 months after the initial diagnosis.CONCLUSIONMultiple primary cancers are influenced by environmental and genetic factors; a standardized multidisciplinary discussion plays a key role in treatment.     

Synchronous development of acute myeloid leukemia in recipient and donor after allogeneic bone marrow transplantation: report of a case with comments on donor evaluation

BACKGROUND: A case of donor cell leukemia (DCL) is reported. A 42-year-old female developed acute myeloid leukemia (AML) of donor cell origin 18 months after a bone marrow transplant (BMT) from her brother. At the time DCL presented, the donor-brother was also diagnosed with AML showing identical cytogenetic abnormalities. The classification of DCL and recommendations for laboratory testing of potential hematopoietic stem cell (HSC) donors are discussed.
STUDY DESIGN AND METHODS: Marrow specimens were obtained from the posterior iliac crest and analyzed using standard techniques. Leukemic cells were analyzed by flow cytometry. Karyotyping and fluorescence in situ hybridization were performed using standard methods.
RESULTS: The recipient-sister's original diagnosis was erythroleukemia. Chromosome analysis showed a 46,XX,t(3;5)(q25;q34) karyotype. Both the recipient's new AML and the donor's AML showed an identical karyotype: 46,XY,inv(3)(q21q26),-7. Both patients were resistant to therapy and died.
CONCLUSION: The clinical and biological aspects of DCL are discussed including the distinction between transformation of healthy donor cells to leukemic cells and transmission of preformed leukemic cells. The former represents almost all the reported cases of DCL compared with transmission of leukemic cells from donor to recipient. With an aging donor population, it is estimated that the latter will increase. Increased testing of older donors to include routine morphologic study of blood and marrow, cytogenetic studies, and evaluation for clonal lymphoproliferative disorders is recommended.     

1例慢性粒细胞白血病伴Sweet综合征的护理

Sweet综合征（Sweet’s syndrome,SS）又称急性发热性嗜中性皮病（acute febrile neutrophilic dermatosis）,1964年由 Robert Dougias Sweet首先提出[1]。本病发病机制不明,可能与特发性或与肿瘤、自身免疫病、感染妊娠、药物等有关,10%~20%的Sweet综合征病人合并潜在的恶性疾病,这些恶性疾病中85%为血液系统肿瘤。最常见的血液恶性肿瘤为急性髓性白血病和骨髓增生异常综合征[2]。Sweet综合征主要表现为发热、皮疹,发热可出现在皮疹前数天至数周,或与皮疹同时发生。典型皮损为痛性隆起的结节红斑,当合并血液病时上肢累及常见,且皮疹常不典型,可表现为脓包的皮损或溃疡,并可逐渐扩大融合成片[3,4]。现将我科收治的1例慢性粒细胞白血病伴 Sweet综合征的护理总结报道如下。     

Reduced-intensity hematopoietic stem cell transplantation and donor lymphocyte infusions for chronic myeloid leukemia

Allogeneic hematopoietic stem-cell transplantation(allo-SCT) is a potentially curative treatment for patients with chronic myeloid leukemia(CML). However, a major obstacle to this approach is a considerably high risk for transplantation-related mortality(TRM) mostly associated with toxic conditioning and graft-versus-host disease(GVHD). Clinical observations that the infusions of allogeneic T-cells can successfully induce remissions in the majority of patients with CML in relapse after allo-SCT lead the way to the exploitation of non-myeloablative or reduced-intensity conditioning for the initial allografting. Current results of reduced-intensity transplants for CML in chronic phase are encouraging, although the incidence of graft rejection and intractable GVHD still remains a great challenge. To enhance graft-versus-leukemia without exacerbating GVHD, further efforts are required to develop cellular immunotherapy more selectively targeting malignant but not normal host cells.     

A case of chronic myelogenous leukemia with the T315I mutation who progressed to myeloid blast phase and was successfully treated with asciminib

Patients with chronic myelogenous leukemia (CML) harboring the T315I mutation who progress to blast phase CML while on ponatinib may be successfully treated with asciminib monotherapy following induction therapy with cytotoxic chemotherapy.     

Engraftment with chronic granulocytic leukemia cells in acute myeloid leukemia

A deliberate engraftment with nonirradiated chronic granulocytic leukemia (CGL) cells was performed in a patient with acute myeloid leukemia (AML) at a time when he was resistant to cytotoxic drug chemotherapy, pancytopenic and developed an infection. The CGL engraftment was confirmed by the presence of a Ph1-positive donor clone in the recipient's bone marrow and by the pattern of colony growth of the recipient's bone-marrow cells cultured in vitro. Bone marrow engraftment in the host helped in the resolution of infection and permitted the administration of further cytotoxic drugs, as a result of which a remission of AML occurred.     

亲属成人间活体肝移植1例临床分析

背景:活体肝移植的开展扩大了供体来源,有效缓解了供肝匮乏的局面,且活体供肝冷缺血时间短、质量好;若供、受者为亲属,可能具有免疫相容的优势.目的:总结1例亲属成人间活体肝移植的临床体会,探讨成人间活体肝移植治疗终末期肝病的手术方式及移植效果.方法:乙型肝炎后肝硬化(失代偿期)并门脉高压症患者1例,女性,年龄54岁,拟行肝移植手术.供者为患者外甥,23岁,既往身体健康.经术前评估后,切取供者右半肝并原位移植给受者.术后常规给予免疫抑制、防治感染、护肝、支持等治疗.结果与结论:术后供者生命体征平稳,手术历时4 h,失血约150 mL,术后第5天肝功能基本恢复正常,术后10 d行上腹部CT平扫加增强提示符合活体肝移植供体右半肝切除术后改变.术后受者生命体征平稳,手术历时7 h,失血约500 mL,彩超检查移植肝血管通畅,血供良好;生化指标逐渐恢复至正常范围,提示移植肝功能情况良好.术后供、受者无严重并发症发生,均健康存活,门诊随访肝功能正常.结果说明成人间活体肝移植为术前周密的准备工作,选择最佳的移植手术时机以及手术的成功创造了最佳条件,是在尸体供肝短缺的情况下治疗终末期肝病的理想方法.