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1例RAEB-t经G-CSF治疗,在接受MST-16治疗后出现完全缓解,继发可逆性白血病

[A case of RAEB-t treated by G-CSF showing complete remission after MST-16 treatment for subsequent reversible leukemia].

作者信息

Murate T, Ohashi H, Kagami Y, Hotta T, Murase T, Hirota Y, Kimura K

机构信息

First Dept. of Internal Medicine, Nagoya University School of Medicine, Japan.

出版信息

Gan To Kagaku Ryoho. 1991 Sep;18(12):2155-8.

PMID:1716093
Abstract

A seventy-five-year-old female with general fatigue, high fever and anemia was admitted. Her chest X-ray film revealed pneumonia. She was diagnosed as RAEB-t with the normal karyotype by peripheral blood film and bone marrow aspiration; 125 micrograms/ml of G-CSF was administered s.c. daily in order to increase neutrophil count because of the prolongation of pneumonia. Her blast cells in both peripheral blood and bone marrow showed a remarkable increase by G-CSF. After the cessation of G-CSF administration, blast cells decreased rapidly, and neutrophil count in the peripheral blood increased. Her pneumonia was then cured. After 5 months of stable hematological state, 60% of her bone marrow cells became occupied by blast cells again. So 2 consecutive courses of 14 days p.o. administration of 1,200 mg MST-16/day were tried. Three months after the first MST-16 trial, her bone marrow showed complete remission (CR) which lasted about 4 months. But she died of sepsis after the first relapse. Her bone marrow in CR still revealed several features of dyspoiesis.

摘要

一名75岁女性因全身乏力、高热和贫血入院。胸部X线片显示肺炎。通过外周血涂片和骨髓穿刺,她被诊断为核型正常的难治性贫血伴原始细胞过多-转变型(RAEB-t);由于肺炎病程延长,每天皮下注射125微克/毫升的粒细胞集落刺激因子(G-CSF)以增加中性粒细胞计数。她外周血和骨髓中的原始细胞因G-CSF而显著增加。停止使用G-CSF后,原始细胞迅速减少,外周血中性粒细胞计数增加。随后她的肺炎治愈。在血液学状态稳定5个月后,她骨髓中60%的细胞再次被原始细胞占据。因此尝试口服给予1200毫克MST-16/天,连续两个疗程,为期14天。首次使用MST-16三个月后,她的骨髓达到完全缓解(CR),持续约4个月。但她在首次复发后死于败血症。她处于CR状态的骨髓仍显示出一些造血异常的特征。

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