BCR-ABL阳性急性髓系白血病1例并文献复习

BCR-ABL positive acute myeloid leukemia:one case report and literature review

急性髓系白血病(acute myeloid leukemia,AML)是一类在临床及细胞遗传学上均具有高度异质性、克隆性的造血干细胞疾病,通常是由多种致病因素共同作用的结果,细胞和分子遗传学异常是其致病基础。BCR-ABL融合基因是由t(9;22)(q34;q11)产生,常见于超过90%的慢性髓性白血病(chronic myeloid leukemia,CML)患者,20%~35%的成人急性B淋巴细胞白血病(B-ALL)及2%~5%的儿童B-ALL患者亦可检测到该融合基因,称为Ph+B-ALL。

To explore the diagnosis,treatment and prognosis of BCR-ABL positive acute myeloid leukemia(AML),we reported a case of BCR-ABL positive AML with clinical features,diagnosis,treatment,prognosis and reviewed the related literature.The patient was a 64-year-old male with a history of 1 month.He had dizziness and nausea as the first manifestation.Blood routine examination showed that hemoglobin reduction and thrombocytopenia,while white blood cells were normal.Primordial cells accounted for 23.5%;immunophenotype showed that CD34,CD117,CD123,CD38 were positive;PCR showed BCR/ABL positive(P190);the chemotherapy of decitabine combined with CIG had not achieve complete remission,but decitabine combined with DA and tyrosine kinase inhibitor had.The patient treated with tyrosine kinase inhibitor and Bcl-2 inhibitor for maintenance treatment.The disease was in remission for more than 3 months.BCR-ABL positive AML is rare type in clinic,and there is no unified treatment plan.The elderly patients can not tolerate standard chemotherapy and hematopoietic stem cell transplantation.Targeted therapy is expected to improve the survival of patients.