急性单核细胞白血病迭患多发性骨髓瘤一例并文献复习

Simultaneous Occurrence of Acute Myeloid Leukemia and Multiple Myeloma: A Case Report and Literature Review

目的:探讨急性髓系白血病迭患多发性骨髓瘤的发生机制、治疗方法及预后。方法:对1例急性单核细胞白血病迭患多发性骨髓瘤患者的病例资料进行分析,并复习相关文献。结果:该例患者行小剂量地西他滨 + 阿克拉霉素 + VRd方案化疗2疗程,小剂量地西他滨 + CAG + 硼替佐米方案化疗1疗程,最终因原发病进展合并严重感染死亡,生存期10个月。结论:此类病例临床罕见,预后差,临床多为个案报道,目前治疗方案仍不能治愈大多数患者,化疗序贯移植或联合新的靶向药物有望延长患者生存期,改善预后。

Objective: To investigate the pathogenesis, treatment and prognosis of simultaneous occurrence of acute myeloid leukemia and multiple myeloma. Methods: The case data of a patient with acute monocytic leukemia complicated with multiple myeloma were analyzed and the related literatures were reviewed. Result: The patient was treated with low dose of decitabine + aclacinomycin + VRd for two courses of chemotherapy, low dose of decitabine + aclacinomycin + bortezomib for one course of chemotherapy. Finally, he died of progression of primary disease with severe infection and survived for 10 months. Conclusion: Such cases are rare in clinic and poor in prognosis, but most of them are reported in individual cases. At present, the treatment scheme cannot cure most patients. Sequential transplantation of chemotherapy or combined with new targeted drugs is expected to prolong the survival time of patients and improve the prognosis.