滤泡型淋巴瘤治疗后继发急性早幼粒细胞白血病1例报告并文献复习

目的：探讨相关性急性早幼粒细胞白血病（t-APL）的临床特点和治疗。方法：报告1例滤泡型淋巴瘤治疗后的（t-APL）,并复习相关文献。结果：1例38岁的滤泡型淋巴瘤患者共接受了20疗程的化疗,包括6疗程的FND（复达拉滨、米托蒽醌、地塞米松）方案。治疗56个月后,患者出现全血细胞减少,骨髓检查诊断为APL,染色体检查为t（15;17）（q22;q12）。在应用全反式维甲酸、亚砷酸和联合化疗治疗后,获完全缓解,但16个月死于淋巴瘤复发。结论：在以复达拉滨为基础的联合化疗方案治疗滤泡型淋巴瘤时,应考虑可能发生t-APL的危险,需密切监测血细胞变化。

Therapy-related acute promyelocytic leukemia following therapy for follicular lymphoma

Objective：To describe the clinical characteristic of therapy-related acute promyelocytic leukemia（t-APL） following therapy for follicular lymphoma.Methods： One case of t-APL was reported and the literatures were reviewed.Results： A 38-year-old man with follicular leukemia received 20 cycles chemotherapy,which included 6 cycles of FND（fludarabine,mitoxantrone,and dexamethasone）.After 56 months,he presented with pancytopenia.Marrow examination showed acute promyelocytic leukemia（APL） and cytogenetic analysis showed an balanced translocation t（15;17）（q22;q12）.He achieved molecular remission after treatment of all-trans retinoic acid,arsenic acid and combined chemotherapy,and died from relapse of follicular lymphoma after 16 months of complete remission of APL.Conclusion： When decision is made to treat follicular lymphoma with fludarabinea-based combination chemotherapy protocols,potential risk for t-APL should be considered and a close clinical and laboratory monitoring is warranted.