儿童急性早幼粒细胞白血病治疗后继发T淋巴母细胞淋巴瘤1例临床报告

A case of clinical report of T-lymphoblastic lymphoma secondary to acute promyelocytic leukemia in children

目的总结急性白血病治疗后继发非霍奇金淋巴瘤患儿的临床诊治过程,探讨疾病相关机理。方法回顾性分析1例急性早幼粒细胞白血病(APL)治疗后继发T淋巴母细胞淋巴瘤(T-LBL)患儿的临床资料,并检索急性白血病治疗后继发非霍奇金淋巴瘤的文献报告进行总结。结果患儿,男,10岁,因“间断发热”起病,确诊APL后,在治疗过程中出现骨髓复燃,调整治疗方案后达完全缓解,然而在结束白血病治疗后因淋巴结肿大诊断为T-LBL,经规范化疗再次得以缓解。检索近10年文献,急性白血病治疗后继发非霍奇金淋巴瘤共报告9例,均为成人病例,其中6例患者至报告时均为无病生存状态。结论急性白血病治疗后继发非霍奇金淋巴瘤的发生率低、预后较好。此外,对肿瘤性疾病化疗后的患者,需注意继发性肿瘤的发生,应用先进检测技术可提高对继发性肿瘤致病机制的认知。

Objective To summarize the clinical process of patients with non-Hodgkin's lymphoma(NHL)secondary to acute leukemia after treatment,and to explore the mechanism of NHL secondary to acute leukemia after treatment.Methods The clinical data of child with T-lymphoblastic lymphoma(T-LBL)secondary to acute promyelocytic leukemia(APL)was retrospectively analyzed,and the literature reports of NHL secondary to acute leukemia after treatment were summarized.Results The patient was a 10-year-old boy who presented with"intermittent fever"and was diagnosed with APL.After treatment,bone marrow relapsed and a complete remission was achieved after adjusting the treatment regimen,however,T-LBL was diagnosed due to enlarged lymph nodes at the end of the leukemia treatment,and remission was achieved again after standardized chemotherapy.Searching the literature over the last 10 years,a total of 9 cases of non-Hodgkin's lymphoma secondary to acute leukemia treatment have been reported,all in adults,and 6 of these patients were disease-free survival up to the time of reporting.Conclusion The incidence of secondary NHL after acute leukemia treatment is low and the prognosis is favorable.In addition,for patients after chemotherapy for neoplastic diseases,it is crucial to monitor the incidence of secondary tumors and employ advanced diagnostic techniques to enhance understanding of the pathophysiology underlying these secondary malignancies.