Kawakami K, Kiyosaki M, Amaya H, Nakamaki T, Hino K, Tomoyasu S
Department of Hematology, Showa University School of Medicine.
Rinsho Ketsueki. 2000 Apr;41(4):334-40.
A 54-year-old female, who had been treated for 4 years in the chronic phase of chronic myelogenous leukemia (CML) was admitted for management of a CML blastic crisis. Blast cells showed strong positive expression of CD7 and HLA-DR, and weakly expressed CD2, CD5 and CD10, as well. The cells were peroxidase negative in peripheral blood and bone marrow. An undifferentiated blastic crisis was diagnosed and she was treated with Interferon-alpha and VP(vincristine 2 mg/week; prednisolone 30 mg/day). A 5-7 mm in diameter tumor in the skin of the anterior right chest appeared one week after VP therapy. The tumor consisted of blasts which were CD13, CD33 and peroxidase positive, unlike the peripheral undifferentiated blasts. This is a rare case of mixed blast crisis with an increase in undifferentiated blasts in peripheral blood and bone marrow, and myeloblastic tumor formation in the skin.
一名54岁女性,慢性粒细胞白血病(CML)慢性期已接受4年治疗,因CML急变期入院治疗。原始细胞显示CD7和HLA - DR呈强阳性表达,同时CD2、CD5和CD10表达较弱。外周血和骨髓中的细胞过氧化物酶阴性。诊断为未分化急变期,给予α干扰素和VP方案(长春新碱2mg/周;泼尼松龙30mg/天)治疗。VP治疗一周后,右前胸皮肤出现一个直径5 - 7mm的肿瘤。该肿瘤由原始细胞组成,与外周未分化原始细胞不同,这些原始细胞CD13、CD33和过氧化物酶呈阳性。这是一例罕见的混合急变期病例,外周血和骨髓中未分化原始细胞增多,皮肤出现髓母细胞瘤形成。