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多发性骨髓瘤初次诊断38个月后发生的继发性淋巴细胞白血病:一例报告。

Secondary lymphoblastic leukemia occurring 38 months after the primary diagnosis of multiple myeloma: A case report.

作者信息

Li Junxun, Zhan Jieyu, Zhang Fan, Ye Zhuangjian, Ouyang Juan

机构信息

Department of Laboratory Science, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510080, P.R. China.

Department of Pediatrics, The First Hospital of Baiyun, Guangzhou, Guangdong 510410, P.R. China.

出版信息

Oncol Lett. 2016 Aug;12(2):847-856. doi: 10.3892/ol.2016.4728. Epub 2016 Jun 15.

Abstract

Multiple myeloma (MM) is a malignant plasma cell neoplasm characterized by the accumulation of plasma cells in the bone marrow, the subsequent destruction of bone and organ dysfunction. The present study describes the case of a 66-year-old male patient who presented with the typical clinical manifestations of MM. The patient was administered a bortezomib and dexamethasone regimen for 2 cycles and achieved complete remission. Lenalidomide, vincristine, pirarubicin, dexamethasone, melphalan and thalidomide was used successively in consolidation therapy and maintenance therapy. The patient developed secondary B-cell lymphoblastic leukemia 38 months after the primary MM diagnosis was made. Owing to the exposure of the patient to a variety of therapeutic agents, it could be inferred that multiple immune defects may have played an important role in the secondary lymphoblastic leukemia of the patient. Microscopic examination and flow cytometry detection were important in identifying the secondary malignancy in this MM case.

摘要

多发性骨髓瘤(MM)是一种恶性浆细胞肿瘤,其特征是骨髓中浆细胞积聚、随后的骨质破坏和器官功能障碍。本研究描述了一名66岁男性患者的病例,该患者表现出MM的典型临床表现。患者接受硼替佐米和地塞米松方案治疗2个周期并实现完全缓解。来那度胺、长春新碱、吡柔比星、地塞米松、美法仑和沙利度胺先后用于巩固治疗和维持治疗。该患者在原发性MM诊断后38个月发生继发性B细胞淋巴细胞白血病。由于该患者接触了多种治疗药物,可以推断多种免疫缺陷可能在该患者的继发性淋巴细胞白血病中起重要作用。显微镜检查和流式细胞术检测对于识别该MM病例中的继发性恶性肿瘤很重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3747/4950900/fc31b197397c/ol-12-02-0847-g00.jpg

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