急性早幼粒细胞白血病完全缓解后出现真性红细胞增多症1例

A case of polycythemia vera after complete remission of acute promyelocytic leukemia

本研究报道本院1例急性早幼粒细胞白血病(APL)完全缓解后出现真性红细胞增多症(PV)的病例,分析其临床资料及相关实验室检查,并作相关文献复习,从而探讨APL完全缓解后出现真性红细胞增多症的可能原因。该患者初诊时外院确诊为APL M3a型,经全反式维甲酸、亚砷酸及DA方案诱导及巩固治疗,并予维甲酸及甲氨蝶呤(MTX)维持治疗后,持续完全缓解,2020年于本院门诊血常规检查发现血红蛋白(Hb)持续异常升高,经一系列相关检查后确诊真性红细胞增多症。APL完全缓解后发生真性红细胞增多症可能与APL的治疗相关,也可能因患者新发基因突变导致,其相关性仍有待进一步讨论。

This paper reports 1 case of polycythemia vera(PV)after complete remission of acute promyelocytic leukemia(APL)in this hospital.The clinical data and related laboratory tests were analyzed,and the related literature was reviewed,so as to investigate the possible causes of true polycythemia vera after complete remission of APL.The patient was diagnosed with APL M3a type at the initial diagnosis.After induction and consolidation treatment with all trans retinoic acid,arsenic acid and DA regimen,and maintenance treatment with retinoic acid and methotrexate(MTX),the patient achieved complete remission.In 2020,hemoglobin(Hb)continued to be abnormally elevated in the outpatient blood routine examination of our hospital,and the diagnosis of polycythemia vera was confirmed after a series of relevant tests.The occurrence of polycythemia vera after complete remission in APL may be caused by the treatment of APL,or may be caused by new gene mutations.The truth remains to be further discussed.