Naito Kotaro, Mori Takehiko, Miyazaki Keiko, Tsukada Yuiko, Ikeda Yasuo, Okamoto Shinichiro
Division of Hematology, Department of Medicine, Keio University School of Medicine, Tokyo.
Intern Med. 2003 Aug;42(8):740-2. doi: 10.2169/internalmedicine.42.740.
We describe a patient with chronic myelogenous leukemia (CML) who developed extramedullary blast crisis, and was successfully treated with imatinib mesylate (STI571). A 42-year-old man had been diagnosed with chronic phase Philadelphia chromosome (Ph)-positive CML and treated with interferon-alpha. He achieved partial cytogenetic response. Two years after the diagnosis, he presented with superficial lymphadenopathy in his neck and supraclavicular regions. Lymph node biopsy disclosed the infiltration of myeloblasts. Although the patient's bone marrow was without increasing blasts at that time, cytogenetic response was no longer observed. STI571 at a dose of 600 mg/day was initiated, and led to the complete disappearance of lymphadenopathy within a month and also to major cytogenetic response in the bone marrow (90% Ph-negative metaphases). Subsequently, the patient underwent allogeneic bone marrow transplantation from an HLA-matched unrelated donor and was in complete remission without evidence of extramedullary disease 12 months after transplantation.
我们描述了一名慢性粒细胞白血病（CML）患者，该患者发生了髓外原始细胞危象，并成功接受了甲磺酸伊马替尼（STI571）治疗。一名42岁男性被诊断为慢性期费城染色体（Ph）阳性CML，并接受了α干扰素治疗。他获得了部分细胞遗传学缓解。诊断两年后，他出现颈部和锁骨上区域浅表淋巴结肿大。淋巴结活检显示有原始粒细胞浸润。尽管当时患者骨髓中的原始细胞没有增加，但不再观察到细胞遗传学缓解。开始使用剂量为600毫克/天的STI571治疗，一个月内淋巴结肿大完全消失，骨髓也出现了主要细胞遗传学缓解（90%的Ph阴性中期分裂相）。随后，该患者接受了来自HLA匹配的无关供体的异基因骨髓移植，移植后12个月完全缓解，无髓外疾病证据。
