粒细胞肉瘤4例的诊治并文献复习

Diagnosis and treatment of 4 patients with granulocytic sarcoma and the literature review

目的增强对粒细胞肉瘤的临床诊断、病理及免疫组织化学、细胞遗传学改变及治疗的认识。方法对4例粒细胞肉瘤患者的临床资料进行分析,并复习相关文献。结果 4例中非白血病型2例,相应治疗后持续缓解;白血病型2例,其中1例源于急性髓系白血病,另1例源于慢性髓系白血病,治疗效果均差,生存时间分别为8个月和4个月。结论粒细胞肉瘤诊断和鉴别诊断主要依靠病理形态学及免疫组织化学,其预后差。早期确诊,及时实施个体化治疗,高强度化疗可延缓复发,提高生存率,造血干细胞移植能够明显延长生存期。

Objective To explore the diagnosis, clinical pathology, immunohistochemistry, cytogenetics and treatment of granulocytic sarcoma（GS）. Methods The clinical data of 4 cases of GS was analyzed, and the related-literatures were reviewed. Results Two cases were non-leukemic GS, currently being in continuous complete remis-sion after appropriate treatment. The other 2 cases were leukemic GS：one case originated from acute myeloid leuke-mia, and the other one originated from chronic myeloid leukemia, the results of the two patients for treatment were poor, the survival time of the two cases was 8 months and 4 months respectively. Conclusion The diagnosis and dif-ferential diagnosis of GS mainly depends on patho-morphology and immunohistochemistry. The prognosis of GS is poor.The early diagnosis, timely implementation of the individualized treatment and early high-intensity chemothera-py can delay the recurrence and improve long-term survival rate;hematopoietic stem cell transplantation can signifi-cantly prolong survival time.