Chen S-W, Hwang W-S, Tsao C-J, Liu H-S, Huang G-C
Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan.
J Clin Pharm Ther. 2005 Dec;30(6):623-5. doi: 10.1111/j.1365-2710.2005.00684.x.
Therapeutic agents for chronic myeloid leukaemia (CML) in the chronic phase include hydroxyurea, interferon alpha, allogeneic stem cell transplantation and the tyrosine kinase inhibitor imatinib (STI 571, Gleevec). For elderly patients, oral hydroxyurea is suitable for the relief of symptoms caused by hyperleukocytosis, and splenic irradiation would be considered if abdominal discomfort or fullness induced by splenomegaly were present. Tumour lysis syndrome (TLS) is seldom seen in the treatment for CML, and TLS caused by hydroxyurea or splenic irradiation is rarely observed. Herein, we report an elderly CML patient who received treatment with hydroxyurea, allopurinol, hydration and splenic irradiation. After 3 days, acute TLS developed. Aggressive supportive treatment, including haemodialysis, stabilized the condition.
慢性期慢性髓性白血病（CML）的治疗药物包括羟基脲、α干扰素、异基因干细胞移植以及酪氨酸激酶抑制剂伊马替尼（STI 571，格列卫）。对于老年患者，口服羟基脲适用于缓解高白细胞血症引起的症状，若存在脾肿大引起的腹部不适或饱胀感，则可考虑进行脾区照射。肿瘤溶解综合征（TLS）在CML治疗中很少见，由羟基脲或脾区照射引起的TLS则更为罕见。在此，我们报告一名老年CML患者，其接受了羟基脲、别嘌醇、水化治疗及脾区照射。3天后，急性TLS发生。积极的支持治疗，包括血液透析，使病情稳定。
