达沙替尼联合α-干扰素致严重的溶血性贫血分析

Interferon-alpha Combined with Dasatinib Caused Severe Hemolytic Anemia in a Case of Chronic Myeloid Leukemia

溶血性贫血与自身免疫性疾病、病毒感染、药物或者肿瘤相关。其诊断标准包括:(1)血红蛋白水平达贫血标准;(2)至少符合以下一条:网织红细胞百分比>4%或绝对值>120×10^(9)/L;结合珠蛋白<100 mg·L^(-1);总胆红素≥17.1μmol·L^(-1)(以非结合胆红素升高为主)。溶血性贫血合并慢性粒细胞白血病非常罕见。现报道了1例加速期慢性粒细胞白血病患者,在使用达沙替尼联合干扰素-α治疗13个月后发生了严重的溶血性贫血。停止联合治疗,并加用泼尼松免疫抑制治疗后,溶血消失。此案例提醒使用达沙替尼联合干扰素治疗时,需警惕特殊严重不良反应的发生,提高用药安全性。

Hemolytic anemia is known to be associated with autoimmune disorders,viral infections,drugs or cancers.However,it is uncommon in chronic myeloid leukemia(CML).Here we report a young patient,who was with CML in accelerated phase and resistant to multi-drug,developed severe autoimmune hemolysis after combined treatment with dasatinib and interferon-α.After stopping combination therapy and giving prednisone treatment for two weeks,hemolysis stopped.