Majado M J, González García C, Marín-Blazquez M D, Morales Lázaro A, Moreno Moreno M
Servico de Hematología, Hospital Virgen de la Arrixaca, Murcia.
Sangre (Barc). 1992 Dec;37(6):465-6.
Philadelphia chromosome-positive chronic myeloid leukaemia (CML) developed three years after the diagnosis of Waldenström macroglobulinemia (WM) in a patient who had received chlorambucil and prednisone during this time. Treatment with busulphan was started and two and a half years later the died in blastic crisis. Six months before the blastic transformation of the leukaemia the amount of IgM, which remains stable (above normal values) along the chronic phase, initiates a decrease, reaching normal values in the phase of acute transformation. CML is a very rare second neoplasia in patients receiving anticancer drugs. The correlation between the decrease of IgM and the blastic crisis is very interesting. We do not find an explanation for this finding although similar observations have been described heralding the appearance of second neoplasias in WM, and one might speculate with a possible role of IgM in the control of chronic phase of the myeloid leukaemia or if the overgrowth of blastic cells could overwhelm the development of lymphoplasmacytoid cells.
一名曾接受苯丁酸氮芥和泼尼松治疗的患者，在诊断为华氏巨球蛋白血症（WM）三年后发生了费城染色体阳性慢性髓性白血病（CML）。开始使用白消安治疗，两年半后患者死于急变期。在白血病急变前六个月，在慢性期一直保持稳定（高于正常值）的IgM量开始下降，在急性转化期降至正常值。CML是接受抗癌药物治疗的患者中非常罕见的第二种肿瘤。IgM下降与急变期之间的相关性非常有趣。尽管已有类似观察结果预示WM中第二种肿瘤的出现，但我们无法对此发现作出解释，人们可能推测IgM在髓性白血病慢性期的控制中可能发挥作用，或者原始细胞的过度增殖是否会抑制淋巴浆细胞样细胞的发育。
