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[脐血移植后急性髓系白血病的心肌浸润及多发性粒细胞肉瘤形成]

[Myocardial infiltration and formation of multiple granulocytic sarcoma of acute myeloid leukemia after cord blood transplantation].

作者信息

Hagihara Maki, Motohashi Kenji, Ohshima Rika, Ito Satomi, Sakuma Yuji, Kameda Yoichi, Maruta Atsuo, Ishigatsubo Yoshiaki, Kanamori Heiwa

机构信息

Department of Hematology, Kanagawa Cancer Center.

出版信息

Rinsho Ketsueki. 2009 Jul;50(7):574-6.

Abstract

A 57-year-old woman was diagnosed with acute myeloid leukemia (AML, M5a) with MLL rearrangement in August 2006. Cord blood transplantation (CBT) conditioned with a reduced-intensity regimen was carried out during second complete remission in March 2007. Marrow study on day 28 confirmed complete chimera and disappearance of minimal residual disease by RT-PCR. She complained of left chest pain around day 120. CT scan on day 127 showed left pleural effusion, tumors of the upper mediastinum and spleen, and pericardial effusion. She suddenly died of cardiogenic shock on day 129. Postmortem examination revealed systemic granulocytic sarcomas and infiltration of leukemic cells into the right atrium and epicardium without recurrence of leukemia in blood and marrow.

摘要

一名57岁女性于2006年8月被诊断为伴有MLL重排的急性髓系白血病(AML,M5a)。2007年3月在第二次完全缓解期进行了减低强度预处理方案的脐血移植(CBT)。第28天的骨髓检查通过逆转录聚合酶链反应(RT-PCR)证实完全嵌合且微小残留病消失。她在第120天左右出现左胸痛。第127天的CT扫描显示左侧胸腔积液、上纵隔和脾脏肿瘤以及心包积液。她在第129天突然死于心源性休克。尸检发现全身性粒细胞肉瘤以及白血病细胞浸润右心房和心外膜,血液和骨髓中无白血病复发。

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