Manabe Masahiro, Okita Junya, Takakuwa Teruhito, Harada Naonori, Aoyama Yasutaka, Kumura Takeo, Ohta Tadanobu, Furukawa Yoshio, Mugitani Atsuko
Dept. of Hematology, Seichokai Fuchu Hospital.
Gan To Kagaku Ryoho. 2014 Jun;41(6):781-4.
A 7 1-year-old man was admitted to our hospital with leukocytosis and anemia. Chronic myelomonocytic leukemia (CMML)harboring del(20q)was diagnosed by peripheral blood examination and bone marrow aspiration. The patient was subsequently treated with azacitidine, which resulted in rapid disappearance of monocytosis and resolved his dependency on red cell transfusion. With regard to the chromosomal abnormality, although del(20q)is estimated to be encountered in approximately 0.7-1.0% of all CMML cases, its significance in prognosis has not been fully analyzed. Hence, more such cases need to be evaluated to elucidate the therapeutic outcome of CMML involving del(20q). In addition, the Wilms tumor-1(WT 1)level in the patient gradually decreased after the initiation of azacitidine therapy. This phenomenon of WT1 decrease synchronizing with the patient's clinical improvement might reflect therapeutic efficacy with regard to the clinical course, as had been observed in acute myeloid leukemia and myelodysplastic syndrome.
一名71岁男性因白细胞增多和贫血入院。通过外周血检查和骨髓穿刺诊断为伴有20号染色体长臂缺失（del(20q)）的慢性粒单核细胞白血病（CMML）。该患者随后接受阿扎胞苷治疗，治疗后单核细胞增多迅速消失，对红细胞输血的依赖也得以缓解。关于染色体异常，虽然估计在所有CMML病例中约0.7 - 1.0%会出现del(20q)，但其对预后的意义尚未得到充分分析。因此，需要评估更多此类病例，以阐明涉及del(20q)的CMML的治疗结果。此外，患者在开始阿扎胞苷治疗后，Wilms肿瘤-1（WT1）水平逐渐下降。WT1水平下降与患者临床改善同步的这一现象，可能如在急性髓系白血病和骨髓增生异常综合征中所观察到的那样，反映了在临床病程方面的治疗效果。
