Flatt Terrie, Neville Kathleen, Lewing Karen, Dalal Jignesh
Division of Hematology/Oncology, Department of Pediatrics, Children's Mercy Hospital, 2401 Gillham Road, Kansas City, MO 64108, USA.
Case Rep Hematol. 2012;2012:396395. doi: 10.1155/2012/396395. Epub 2012 Apr 1.
Fanconi anemia is associated with an increased risk of malignancy. Patients are sensitive to the toxic effects of chemotherapy. We report the case of a patient with Fanconi anemia who developed T-cell acute lymphoblastic leukemia. He experienced chemotherapy-related complications including prolonged neutropenia, grade IV vincristine neuropathy, and disseminated aspergillosis. He was successfully treated with modified dosing of cytarabine and intrathecal methotrexate followed by allogeneic bone marrow transplant. The aspergillosis was treated with systemic antifungal treatment and surgical resection. Now 30 months after bone marrow transplant the patient is without evidence of aspergillosis or leukemia.
范可尼贫血与恶性肿瘤风险增加相关。患者对化疗的毒性作用敏感。我们报告了一例患有范可尼贫血并发展为T细胞急性淋巴细胞白血病的患者。他经历了化疗相关并发症,包括长期中性粒细胞减少、IV级长春新碱神经病变和播散性曲霉病。他通过调整阿糖胞苷剂量和鞘内注射甲氨蝶呤成功治疗,随后接受了异基因骨髓移植。曲霉病采用全身抗真菌治疗和手术切除。骨髓移植30个月后,患者目前没有曲霉病或白血病的迹象。