浆细胞白血病8例临床及实验室分析

Plasmacytic leukemia:Clinical feature and laboratory results of 8 cases.

目的 探讨浆细胞白血病 (PCL)的临床特点、疗效及预后。方法 对 8例PCL的临床表现及实验进行回顾性分析 ,观测浆细胞直径及形态与多发性骨髓瘤 (MM )细胞进行比较。结果 8例PCL有如下特点 :(1)起病急骤 ,8例患者确诊前平均病程为 2 7个月。 (2 )发病率男性明显多于女性 (7∶1) ,PPCL多于SPCL(7∶1)。 (3)常有发热、骨痛、出血、体重减轻等表现 ,伴有胸骨压痛、肝脾淋巴结肿大者远比MM发生率高。 (4 )骨质破坏率较MM增高。 (5 )球蛋白多数增高 ,血沉明显增快 ,尿素氮升高或出现蛋白尿 ,此与MM相似。 (6 )血液化验多数患者贫血明显 ,血小板降低 ,而白细胞升高。 (7)PCL细胞多数体积偏小 ,核浆比例大。疗效 :3例未经治疗者 3个月内死亡 ,5例接受治疗者 1例完全缓解 (CR) ,2例部分缓解 (PR) ,2例无效。其中 1例持续CR已 6年 5个月并恢复工作 ,1例PR达 2年 11个月 ,仍在治疗中。结论 PCL是类似于MM的急性白血病 ,确诊后尽早采用以烷化剂为主的联合化疗 ,并坚持系统治疗 ,部分患者可以获得长生存。

Objective To explore the clinical feature,curative effects and prognosis of plasmacytic leukemia (PCL).Methods Clinical features and related laboratory results of 8 cases of PCL were analyzed retrospectively.The diameters and morphology of plasma cells of PCL and multimyloma(MM) were measured and observed respectively and the results were compared.Results Three untreated cases of PCL died within 3 months.Among 5 cases of treated PCL,there were one complete remission,two partial remission and two without remission.Of them,one has been in complete remission for 77 months and another one in partial remission for 35 months.Conclusion PCL is one of the acute leukemias resembling MM.The combination chemotherapy including alkylating agent should be adopted as soon as possible when the diagnosis is confirmed.Systemic treatment may prolong the survival time of PCL patients.