Higuchi Masakazu, Nishinaka Hidekazu, Yamano Yujiro
Dept. of Internal Medicine, Kyushu Koseinenkin Hospital.
Gan To Kagaku Ryoho. 2006 Dec;33(13):2049-52.
A 55-year-old woman had received total gastrectomy for advanced gastric cancer in March 2002, and was subsequently treated with adjuvant chemotherapy using oral anti-metabolite TS-1 for 21 months. She was well with no evidence of recurrence of gastric cancer, but leukocytosis was found in June 2005. The analysis of bone marrow revealed that Philadelphia (Ph) chromosome and bcr-abl fusion gene were positive. On the basis of these findings, the chronic phase of secondary chronic myeloid leukemia (CML) was diagnosed. Three months after being started on imatinib therapy, Ph chromosome positive cells disappeared in the bone marrow, and a complete cytogenetic response was achieved. Although CML is rare in secondary leukemia, this is, to our knowledge, the first reported case of therapy-related CML following TS-1 treatment. The present case suggested that imatinib therapy was also effective for secondary CML as well as de novo CML.
一名55岁女性于2002年3月因进展期胃癌接受了全胃切除术，随后使用口服抗代谢药物替吉奥进行辅助化疗21个月。她情况良好，无胃癌复发迹象，但在2005年6月发现白细胞增多。骨髓分析显示费城（Ph）染色体和bcr-abl融合基因呈阳性。基于这些发现，诊断为继发性慢性髓性白血病（CML）慢性期。开始伊马替尼治疗三个月后，骨髓中Ph染色体阳性细胞消失，实现了完全细胞遗传学缓解。虽然CML在继发性白血病中很少见，但据我们所知，这是首例报道的替吉奥治疗后发生的治疗相关CML病例。本病例提示伊马替尼治疗对继发性CML以及原发性CML均有效。
