急性红白血病伴重度核型异常诊治1例附文献复习

Diagnosis and treatment of acute erythroleukemia with major karyotypic abnormalities: report of one case and review of literature

目的:探讨急性红白血病(M6)伴重度核型异常(MAKA)患者的临床特点、实验室检查结果及预后情况。方法:分析讨论1例M6伴MAKA患者的临床资料,并进行文献复习。结果:该例患者经骨髓病理学、免疫组化等诊断为急性红白血病(M6a亚型)伴MAKA,核型为45-47,XX,-8,9q-,+18,+22,+M[CP8]/46,XX,9q-[CP2]。经DA等方案化疗2个疗程后患者病情缓解,且10个月后复查染色体核型提示恢复正常。至2008年10月,随访13个月,患者仍处于无病生存,持续完全缓解10个月余,病程中各重要脏器功能均正常。结论:急性红白血病(M6a亚型)伴MAKA患者化疗后染色体核型有可能恢复正常,这提示其对化疗反应良好,预后将相对较好。

Objective To identify the clinical and pathological features of acute erythroleukemia （M6） with major karyotypic abnormalitics （MAKA）. Methods The characteristics of acute erythroleukemia were discussed with a case report and review of literatures. Result The patient was diagnosed as acute erythroleukemia （M6,） with MAKA by pathology and immunohistochemistry. Complete remission was achieved after two courses of primary induction chemotherapy and 10 months later, the karyotype returned to normal. At present, the patient is alive and disease-free, the period of continuous complete remission up to now is 10 months. The function of important organs maintained in normal status during the therapeutic course. Conclusions Acute erythroleukemia （Ms, subtype） with major karyotypic abnormalities may have a good response to treatment and favorable prognosis, with the patient＇s karyotype returns to normal after chemotherapy.