Zeng Dong-Feng, Chang Cheng, Li Jie-Ping, Kong Pei-Yan, Zhang Xi, Gao Lei
Department of Hematology, Xinqiao Hospital, The Third Military Medical University, Chongqing 400037, P.R. China.
Exp Ther Med. 2015 Mar;9(3):850-852. doi: 10.3892/etm.2015.2173. Epub 2015 Jan 9.
Extramedullary T-lymphoblastic blast crisis of chronic myelogenous leukemia (CML) is uncommon and the prognosis is poor. It was usually misdiagnosed as the co-existence of T-lymphoblastic lymphoma (T-LBL) and CML. In the present study, we report a patient with CML, who developed extramedullary T-lymphoblastic blast crisis and was successfully treated with human leukocyte antigen (HLA)-mismatched stem cell transplantation. The patient was a 44-year-old man who presented with lymphadenectasis and leucocytosis prior to diagnosis. The bone marrow smear, biopsy and fluorescence hybridization (FISH) of Breakpoint Cluster Region/ Abelson murine leukaemia (BCR/ABL) supported the diagnosis of CML in the chronic phase, while the immunohistochemistry of lymph nodes supported the diagnosis of T-LBL. The FISH test for BCR/ABL in lymph node blast cells was performed and the result was positive; therefore, the patient was diagnosed with extramedullary T-lymphoblastic blast crisis of CML. After several courses of combined chemotherapy, the patient was treated with HLA-mismatched stem cell transplantation and obtained continuous remission for 51 months until the present (September 2013).
慢性髓性白血病（CML）的髓外T淋巴细胞母细胞危象并不常见，预后较差。它通常被误诊为T淋巴细胞母细胞淋巴瘤（T-LBL）与CML并存。在本研究中，我们报告了1例CML患者，该患者发生了髓外T淋巴细胞母细胞危象，并通过人类白细胞抗原（HLA）配型不合的干细胞移植成功治愈。患者为44岁男性，诊断前出现淋巴结肿大和白细胞增多。骨髓涂片、活检以及断点簇集区域/阿贝尔森鼠白血病病毒（BCR/ABL）荧光原位杂交（FISH）支持慢性期CML的诊断，而淋巴结免疫组化支持T-LBL的诊断。对淋巴结母细胞进行了BCR/ABL的FISH检测，结果呈阳性；因此，该患者被诊断为CML的髓外T淋巴细胞母细胞危象。经过几个疗程的联合化疗后，该患者接受了HLA配型不合的干细胞移植，并持续缓解达51个月直至目前（2013年9月）。
