原发性肿瘤或其他疾病治疗后发生的慢性髓性白血病。
Chronic Myeloid Leukemia Following Treatment for Primary Neoplasms or Other Medical Conditions.
作者信息
Yang Lian-He, Su Pu, Luedke Catherine, Lu Chuanyi Mark, Louissaint Abner, McCall Chad M, Rapisardo Sarah, Vallangeon Bethany, Wang Endi
机构信息
Department of Pathology, First Affiliated Hospital and College of Basic Sciences of China Medical University, Shenyang, China.
Department of Pathology, Duke University Medical Center, Durham, NC.
出版信息
Am J Clin Pathol. 2018 Jul 31;150(3):246-258. doi: 10.1093/ajcp/aqy050.
OBJECTIVES
Therapy-related chronic myeloid leukemia (CML) has been reported, but its clinical presentation and pathologic features have not yet been well characterized.
METHODS
Twenty-one cases of CML following treatment for primary diseases were collected and retrospectively analyzed.
RESULTS
The clinical presentation, pathologic features, and cytogenetic profile were similar to de novo CML. In particular, those with an isolated Philadelphia chromosome constituted 88.9% of our cases, and additional aberrations characteristic of therapy-related acute myeloid leukemia/myelodysplastic syndrome (AML/MDS) were not identified in this study. The patients responded to imatinib/derivatives and survived with limited follow-up.
CONCLUSIONS
Therapy-related CML has a clinical presentation, pathologic features, and cytogenetic profile akin to de novo CML. Absence of additional significant aberrations seems to suggest a pathogenesis different from therapy-related AML/MDS. Therapy-related CML exhibits a robust therapeutic response to imatinib/derivatives and favorable clinical outcomes similar to de novo CML.
目的
已有治疗相关慢性髓系白血病（CML）的报道，但其临床表现和病理特征尚未得到充分描述。
方法
收集21例原发性疾病治疗后发生CML的病例并进行回顾性分析。
结果
临床表现、病理特征和细胞遗传学特征与初发CML相似。特别是，单纯费城染色体阳性的病例占我们研究病例的88.9%，本研究未发现治疗相关急性髓系白血病/骨髓增生异常综合征（AML/MDS）的其他特征性畸变。患者对伊马替尼/衍生物有反应，在有限的随访期内存活。
结论
治疗相关CML的临床表现、病理特征和细胞遗传学特征与初发CML相似。未发现其他明显畸变似乎提示其发病机制与治疗相关AML/MDS不同。治疗相关CML对伊马替尼/衍生物表现出强烈的治疗反应，临床结局良好，与初发CML相似。
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