Brähler Sebastian, Thielen Indra, Schwabe Hendrik, Engels Marianne, Kreuzer Karl-Anton, Wolf Jürgen, Ansén Sascha
Department II of Internal Medicine, University of Cologne, Cologne, Germany.
Eur J Haematol. 2014 Jun;92(6):537-40. doi: 10.1111/ejh.12254. Epub 2014 Jan 25.
Isolated myeloid sarcoma is a rare presentation of acute myeloid leukemia. There are limited data available concerning the prognostic relevance and the right treatment strategy for this clinical scenario. Here, we report a case of acute myeloid leukemia with extensive lesions and fractures in multiple bones in a 64-yr-old male patient. Remarkably, treatment with a high-dose cytarabine regimen led to rapid remineralization of all bone lesions and recovery of the patient's mobility within a few weeks. Thereby, surgical treatment and radiotherapy could be avoided, supporting the role of intensive induction and standard consolidation chemotherapy as first-line treatment for myeloid sarcoma.
孤立性髓系肉瘤是急性髓系白血病的一种罕见表现。关于这种临床情况的预后相关性和正确治疗策略的可用数据有限。在此,我们报告一例64岁男性急性髓系白血病患者,其多处骨骼出现广泛病变和骨折。值得注意的是,采用大剂量阿糖胞苷方案治疗后,所有骨病变在数周内迅速再矿化,患者的活动能力恢复。因此,避免了手术治疗和放疗,支持强化诱导和标准巩固化疗作为髓系肉瘤一线治疗的作用。