Camós Mireia, Esteve Jordi, Rimola Antoni, Grande Luis, Rozman María, Colomer Dolors, Villamor Neus, Costa Dolors, Montserrat Emili
Department of Hematology, Hemopathology Unit, Institute of Hematology and Oncology, Hospital Clínic, Barcelona, Spain.
Transplantation. 2004 Jan 27;77(2):311-3. doi: 10.1097/01.TP.0000102549.40531.13.
Acute myeloid leukemia (AML) after solid organ transplantation is rare, with only six AML cases after liver transplantation (LT) being reported.
Characteristics of three AML cases observed among 799 recipients of LT in the authors' institution and estimation of the standardized incidence ratio (SIR) are presented.
Three AML cases were diagnosed (French-American-British classification subtypes M0, M3, and M1) at 38 days, 2 years, and 3.5 years after LT, respectively. The immunosuppressive regimen consisted of cyclosporine A and prednisone. The recipient's origin of blasts could be demonstrated in two cases. All patients achieved complete remission after standard treatment. Nonetheless, disease relapsed in two patients at 2 and 6 months, whereas the patient with acute promyelocytic leukemia remains disease-free 4 years after diagnosis. As compared with the general population, the observed incidence of AML in the authors' series of LT results in a significantly higher SIR of 11.41 (P=0.0023).
The higher SIR found in the authors' series suggests an increased risk of AML in patients undergoing LT.
实体器官移植后发生急性髓系白血病（AML）较为罕见，仅有6例肝移植（LT）后发生AML的病例报道。
介绍了作者所在机构799例LT受者中观察到的3例AML病例的特征以及标准化发病比（SIR）的估算情况。
3例AML病例分别在LT后38天、2年和3.5年被诊断出来（法国-美国-英国分类亚型分别为M0、M3和M1）。免疫抑制方案包括环孢素A和泼尼松。2例病例中可证实原始细胞的来源。所有患者经标准治疗后均达到完全缓解。尽管如此，2例患者分别在2个月和6个月时疾病复发，而急性早幼粒细胞白血病患者在诊断后4年仍无病生存。与一般人群相比，作者系列LT中观察到的AML发病率导致SIR显著升高，为11.41（P = 0.0023）。
作者系列中发现的较高SIR表明LT患者发生AML的风险增加。
