Buxó Costa J, Sans-Sabrafen J, Rodríguez Ferrera J C, Boleda Relats M
Med Clin (Barc). 1979 May 25;72(10):418-20.
A case of Schilling type pure acute monocytic leukaemia (M5 variety of the FAB classification) in a 38-year-old man is presented. The initial predominant clinical manifestation was an increase hypertrophic gingivitis. The cytological type was established according to the morphologic and cytochemical criteria currently in use. The patient was treated with daunomycin (60 mg/m2 one day) and ARA-C (100 mg/m2/12 hours for 7 days) in a 2-week interval cycles. Total remission was achieved after the fifth series. The series have been repeated over 4 years with intervals of up to 6 or 8 weeks. Complete haematologic remission has been constant, with normalization of the serum muramidase levels. A gingival biopsy taken at the same time has shown no evidence of leukaemic infiltration. The high incidence of malignancy in this cytological variety of acute leukaemia is pointed out; it is normally less sensitive to chemotherapy than the myeloid types. Remission has been total over a long period of time, which is exceptional in this type of leukaemia. The mean survival rate as recorded in the literature is only a little over 3 months.
本文报告了一例38岁男性的希林型纯急性单核细胞白血病（FAB分类中的M5型）。最初的主要临床表现为增生性牙龈炎加重。根据目前使用的形态学和细胞化学标准确定了细胞类型。患者接受柔红霉素（60mg/m²，一日一次）和阿糖胞苷（100mg/m²/12小时，共7天）治疗，每2周为一个疗程。在第五个疗程后实现了完全缓解。此后的4年中，疗程以长达6至8周的间隔重复进行。完全血液学缓解持续存在，血清溶菌酶水平恢复正常。同时进行的牙龈活检未显示白血病浸润迹象。指出了这种急性白血病细胞类型中恶性肿瘤的高发病率；它通常对化疗的敏感性低于髓系类型。长期完全缓解在这类白血病中实属罕见。文献记载的平均生存率仅略高于3个月。
