Iwasaki Junko, Onozawa Masahiro, Takahashi Shojiro, Okada Kohei, Takahata Mutsumi, Shigematsu Akio, Kahata Kaoru, Kondo Takeshi, Hashino Satoshi, Imamura Masahiro, Asaka Masahiro
Department of Gastroenterology and Hematology, Hokkaido University Graduate School of Medicine.
Rinsho Ketsueki. 2011 Mar;52(3):124-8.
A 56-year-old female was diagnosed with acute myeloid leukemia (FAB: AML-M1). G-banding karyotype of her bone marrow showed complete tetraploidy (92, XXXX [24/24]). Although she achieved complete remission (CR) after induction therapy and maintained CR during consolidation therapy, relapse occurred only 2 months after discharge. When the relapse occurred, bone marrow karyotypic analysis showed complete tetraploidy again. The patient received reduced-intensity cord blood transplantation (RI-CBT), which induced CR for the second time. The patient is currently alive 24 months after transplantation and there have not been any signs of recurrence to date. There have been a few reports of AML with near-tetraploidy, but cases of AML with complete tetraploidy are extremely rare. Tetraploid AML has been reported to have a poor prognosis and there have been very few cases maintaining CR over the long term after chemotherapy alone. This is the first case of complete tetraploid AML successfully treated by RI-CBT. The clinical course of this case suggests that hematopoietic stem cell transplantation during the first CR phase should be considered a treatment option for tetraploid AML.
一名56岁女性被诊断为急性髓系白血病（FAB：AML-M1）。其骨髓的G显带核型显示为完全四倍体（92, XXXX [24/24]）。尽管她在诱导治疗后达到完全缓解（CR），并在巩固治疗期间维持了CR，但出院仅2个月后就复发了。复发时，骨髓核型分析再次显示为完全四倍体。该患者接受了低强度脐血移植（RI-CBT），第二次诱导达到CR。患者目前在移植后24个月仍存活，至今未出现任何复发迹象。有一些关于近四倍体AML的报道，但完全四倍体AML的病例极为罕见。据报道，四倍体AML预后较差，仅通过化疗长期维持CR的病例非常少。这是首例通过RI-CBT成功治疗的完全四倍体AML病例。该病例的临床过程表明，对于四倍体AML，首次CR阶段的造血干细胞移植应被视为一种治疗选择。
