Badelita S, Dobrea C, Colita A, Dogaru M, Dragomir M, Jardan C, Coriu D
Centre of Hematology and Bone Marrow Transplant, "Fundeni" Clinical Institute, Bucharest, Romania.
Centre of Hematology and Bone Marrow Transplant, "Fundeni" Clinical Institute, Bucharest, Romania ; "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.
J Med Life. 2015 Jan-Mar;8(1):55-61.
Multiple myeloma and JAK2 positive chronic myeloproliferative neoplasms are hematologic malignancies with a completely different cellular origin. Two cases of simultaneous occurrence of multiple myeloma, one with primary myelofibrosis and another one with essential thrombocythemia are reported in this article. In such cases, an accurate diagnosis requires a molecular testing, including gene sequencing and differential diagnosis of pancytosis associated with splenic amyloidosis. In general, in such cases, of two coexisting malignant hematologic diseases, the treatment of the most aggressive one is recommended. For our two cases, it was decided to start a Velcade based therapy. The main concern was the medullar toxicity, especially when a multiple myeloma was associated with a primary myelofibrosis.
多发性骨髓瘤和JAK2阳性慢性骨髓增殖性肿瘤是起源完全不同的血液系统恶性肿瘤。本文报道了2例同时发生多发性骨髓瘤的病例,其中1例合并原发性骨髓纤维化,另1例合并原发性血小板增多症。在此类病例中,准确诊断需要进行分子检测,包括基因测序以及与脾淀粉样变性相关的全血细胞减少的鉴别诊断。一般来说,在此类病例中,对于两种并存的恶性血液病,建议治疗其中侵袭性最强的一种。对于我们的这2例病例,决定开始基于万珂的治疗。主要担忧的是骨髓毒性,尤其是当多发性骨髓瘤合并原发性骨髓纤维化时。