一例少见原始细胞伴有Auer存在的变异型急性早幼粒细胞白血病病例报道

A Case Report of Rare Variant Acute Promyelocytic Leukemia with High Rate of Myeloblast and Auer Body

目的:报道一例少见类型的可变型急性早幼粒细胞白血病(M3V)患者的病历资料,并进行文献复习,总结M3V的临床特点和诊治措施。方法:对病例资料进行对比分析,运用图例,同时通过文献回顾研究M3V的特点及发生、发展及诊疗情况。结果:本病例骨髓以原始粒细胞为主,核仁明显,并有Auer小体,免疫表型为CD34^+CD2^+CD117^-CD13^+CD33^+。结论:本病例与以往大多数报道的M3V典型特点不完全一致,体现了M3V细胞形态及免疫表型的复杂多变性。APL病情凶险,进展迅速,若不及时干预,死亡率高,需要快速诊断,早期干预治疗,以减少早期出血和DIC的发生从而降低死亡率。对于实验室诊断困难而临床特点疑似APL的患者在实验室最终诊断结果做出前给予必要的经验性治疗是合理的。

Objective： We reported a case of a rare type of variable acute promyelocytic leukemia （M3V） ,reviewed the literatures and summarized the clinical features and diagnostic measures of M3V. Methods： Clinical data carries on the contrast analysis, use diagram, at the same time, through the literature review research m3v characteristics and occurrence, development, diagnosis and treatment. Results： In this case, the bone marrow of the patients is mainly with the original granulocyte, the prominent, and the Auer body, and the immune phenotype is CD34＋CD2＋CD117-CD13＋CD33＋. Conclusions： This case and most reported M3V typical characteristics are not entirely consistent, reflecting the complexity of cell morphology and immunophenotype of the M3V. APL is a dangerous disease, with a characteristic of rapid progression and high mortality. The incidence of early bleeding and DIC would increase, without timely intervention. It is reasonable to give the necessary empirical treatment for patients with suspected APL Before final diagnosis is made in the laboratory.