Pingali Sai Ravi Kiran, Mathiason Michelle A, Lovrich Steven D, Go Ronald S
Department of Medical Education, Gundersen Lutheran Medical Foundation, La Crosse, Wisconsin, USA.
Clin Lymphoma Myeloma. 2009 Oct;9(5):E25-9. doi: 10.3816/CLM.2009.n.080.
We report the emergence of chronic myelogenous leukemia (CML) in a patient with JAK2V617F-positive polycythemia vera after 15 years of phlebotomy. The polycythemia vera clinical and molecular findings were suppressed at the time of CML diagnosis, only to re-emerge after the leukemia was successfully treated with imatinib. We explored the potential association between myeloproliferative disorders and CML in the context of the current literature and found a higher-than-expected coincidence based on known epidemiologic data for each specific condition. We hypothesize that myeloproliferative disorder (JAK2V617F or molecular events that cause JAK2V617F) is a risk factor for CML (BCR-ABL translocation). Because of therapeutic implications, clinicians should be aware that the conditions co-occur more frequently than once thought.
我们报告了1例真性红细胞增多症患者在放血治疗15年后出现慢性粒细胞白血病(CML),该患者JAK2V617F呈阳性。在CML诊断时,真性红细胞增多症的临床和分子学表现受到抑制,但在白血病用伊马替尼成功治疗后又再次出现。我们结合当前文献探讨了骨髓增殖性疾病与CML之间的潜在关联,发现基于每种特定疾病的已知流行病学数据,两者同时出现的几率高于预期。我们推测骨髓增殖性疾病(JAK2V617F或导致JAK2V617F的分子事件)是CML(BCR-ABL易位)的一个危险因素。鉴于其治疗意义,临床医生应意识到这两种疾病同时出现的频率比以往认为的更高。