以多发骨质破坏为主要表现的淋巴母细胞白血病/淋巴瘤2例并文献复习

目的探讨以多发骨质破坏为主要表现的淋巴母细胞白血病/淋巴瘤患者的临床特点,以提高对该病的认识。方法回顾性分析解放军第306医院血液肿瘤科收治的2例以多发骨质破坏为主要表现的淋巴母细胞白血病/淋巴瘤患者的临床表现、实验室特征及治疗经过并复习国内外相关文献。结果所分析2例患者诊断为B-淋巴母细胞白血病/淋巴瘤伴重现性遗传学异常,多发骨质破坏为主要临床表现,无高钙血症,病初血常规异常不明显,外周血分类未见幼稚细胞,LHD明显升高,骨髓广泛受累,伴有IgH基因重排及超二倍体异常,采用急性淋巴细胞白血病(ALL)样方案化疗,近期疗效尚可。结论多发骨破坏可以是淋巴母细胞白血病/淋巴瘤的主要表现,应给予关注。

Two cases and literature review of lymphoblastic leukemia/lymphoma with multiple bone destruction as the main manifestation

Objective To deepen understanding to the disease of lymphoblastic leukemia/ lymphoma through studying the clinical features of ?the multiple bone destruction as the main manifestation.Methods Retrospective analysis the clinical manifestations,laboratory features and treatment of ?2 patients of lymphoblastic leukemia/lymphoma with multiple bone destruction as the main manifestation treated in ?the Dept.of Hematology and Oncology of 306 Hospital of PLA,and reviewed ?the related literatures.Results The 2 cases diagnosed as B-lymphoblastic leukemia / lymphoma with reproducible genetic abnormalities,multiple bone destruction as the main clinical manifestations,no hypercalcemia,no obvious abnormalities in early blood routine examination,no naive cells in peripheral blood Classification,LDH increased significantly,bone marrow involvement extensively,accompanied by IgH gene rearrangement and hyperdiploid abnormalities,applied acute lymphoblastic leukemia(ALL)-like protocol to chemotherapy,curative effect is acceptable.Conclusion It should be paid attention that the multiple bone destruction can be the main manifestation of lymphoblastic leukemia / lymphoma.