Najean Y, Pecking A
Br J Haematol. 1977 Sep;37(1):25-33.
In a cooperative trial, 90 patients with refractory anaemia with an excess of blast cells in the marrow were evaluated and treated with androgens. The clinical presentation was very similar to previously published observations: features of medullary insufficiency were less marked than in primary aplastic anaemia; bone marrow blastic infiltration varied from case to case, and remained stable until death or until an acute leukaemic change. All the patients were treated with high doses of androgens as for aplastic anaemia. The efficacy of this therapy was poor. The average life expectancy was 13 months, 64% of deaths being associated with a change to acute myeloid leukaemia. A severe bone marrow deficiency foreshadowed early death, but myeloblastic transformation was observed whatever the initial degree of blastic infiltration of the bone marrow. A comparison with the literature suggests that androgen therapy may accelerate the change to acute leukaemia.
在一项合作试验中，对90例骨髓中原始细胞过多的难治性贫血患者进行了评估并用雄激素进行治疗。临床表现与先前发表的观察结果非常相似：骨髓功能不全的特征不如原发性再生障碍性贫血明显；骨髓原始细胞浸润因病例而异，直至死亡或发生急性白血病变化之前一直保持稳定。所有患者都像治疗再生障碍性贫血一样接受了高剂量雄激素治疗。这种治疗方法效果不佳。平均预期寿命为13个月，64%的死亡与转变为急性髓细胞白血病有关。严重的骨髓缺乏预示着早期死亡，但无论骨髓原始细胞浸润的初始程度如何，均观察到了原始粒细胞转化。与文献比较表明，雄激素治疗可能会加速向急性白血病的转变。
