Yamamoto Yoshihisa, Ishii Kazuyoshi, Nomura Shosaku, Fukuhara Shirou
Division of Hematology, Kishiwada City Hospital.
Rinsho Ketsueki. 2004 Feb;45(2):164-6.
We report a case of chronic myeloid leukemia (CML) with clonal Philadelphia negative hematopoiesis arising after treatment with imatinib. A 45-year-old man was diagnosed as having Ph-positive CML. Therapy with MCNU and hydroxyurea was carried out for 12 days, and was then replaced by imatinib. A major cytogenetic response was obtained after 13 months of therapy with imatinib, but at the same time a new Ph-negative clone with trisomy 8 appeared in the bone marrow. Blood cell counts were still within normal limits. This observation indicates that patients on imatinib should be followed with bone marrow morphologic finding and routine cytogenetic testing, even after induction of a good response.
我们报告1例慢性髓系白血病(CML)患者,其在接受伊马替尼治疗后出现克隆性费城染色体阴性造血。一名45岁男性被诊断为Ph阳性CML。使用甲基亚硝脲(MCNU)和羟基脲治疗12天,之后换用伊马替尼。伊马替尼治疗13个月后获得主要细胞遗传学缓解,但同时骨髓中出现了伴有8号染色体三体的新的Ph阴性克隆。血细胞计数仍在正常范围内。这一观察结果表明,即使在诱导产生良好反应后,接受伊马替尼治疗的患者仍应进行骨髓形态学检查和常规细胞遗传学检测随访。