地西他滨治疗继发于多发性骨髓瘤的急性髓系白血病1例

Acute Myeloid Leukemia Secondary to Multiple Myeloma Treated with Decitabine: One Case Report

目的探讨多发性骨髓瘤继发急性髓系白血病的临床特点及地西他滨的疗效。方法继发于多发性骨髓瘤(不分泌型)的急性髓系白血病患者1例,女,62岁,经VAD方案化疗后缓解,此后给予苯丙氨酸氮芥维持治疗。3年后患者继发急性髓系白血病,经DA方案治疗后无明显好转,间断予地西他滨治疗2个疗程。结果患者骨髓原始细胞明显下降,血常规基本恢复正常,此后因为经济原因仅接受支持治疗。结论多发性骨髓瘤继发急性髓系白血病的发病机制不清,治疗相关和疾病本身因素可能参与其中。该类疾病治疗效果不佳,地西他滨为主的治疗方案可以作为首选。

Objective To explore theclinical characteristics of acute myeloid leukemia secondary to multiple myeloma and therapeutic effect of decitabine. Methods A 62-year-old female who developed acute myeloid leukemia secondary to multiple myeloma remitted 3 years after the VAD chemotherapy followed by phenyl alanine nitrogen mustard maintenance therapy. No significant improvement was observed in with DA regimen. The patient was then treated with decitabine intermittently for two courses. Results The bone myeloid progenitor ceils of the patient were decreased significantly, and the blood routine examination recovered. The patient only received supportive treatment for economic reasons thereafter, Conclusion The pathogenesis mechanisms of acute myeloid leukemia secondary to multiple myeloma is far from elucidated. Treatment-related factors and disease involvement may be the main contributions. Decitabine maybe the first choice for disease with poor prognosis.