一名86岁患有AML1/ETO的急性髓性白血病男性患者接受高三尖杉酯碱和三氧化二砷治疗：病例报告。
Acute myeloid leukemia in an 86-year-old man with AML1/ETO treated with Homoharringtonine and Arsenic Trioxide: A case report.
作者信息
He Zhipeng, Chen Meiling, Huang Yiping, Chen Lili, Wang Bixin, Wang Huixian, Yang Mengting, Xiao Xueting, Lu Yanhong, Chen Jiaying, Wu Yong
机构信息
Department of Hematology, Union Hospital, Fujian Medical University, Fujian Institute of Hematology, Fujian Provincial Key Laboratory of Hematology, Fuzhou, China.
出版信息
Medicine (Baltimore). 2019 Mar;98(13):e14998. doi: 10.1097/MD.0000000000014998.
RATIONALE
Acute myeloid leukemia (AML) is a malignantly clonal and highly heterogeneous disease. Although the treatment of AML has brought promising outcomes for younger patients, prognosis of the elderly remains dismal. Innovative regimens are increasingly necessary to be investigated.
PATIENT CONCERNS
We present an 86-year-old AML patient with fever, cough, and sputum production.
DIAGNOSES
A diagnosis of AML with maturation (AML-M2) and AML1/ETO was made.
INTERVENTIONS
The patient was treated with a regimen of Homoharringtonine coupled with arsenic trioxide.
OUTCOMES
The AML-M2 patient with AML1/ETO achieved incomplete remission, but showed few toxic side effects and improved survival. Besides, we analyzed the dynamic counts of complete blood cells during the treatment. The count of white blood cell had a positive correlation with the percentage of blast cells (r = 0.65), both of which had a negative correlation with the percentage of segmented neutrophils (r = -0.63, -0.89).
LESSONS
Homoharringtonine and arsenic trioxide may induce both the apoptosis and differentiation of leukemic cells in AML-M2 with AML1/ETO.
原理
急性髓系白血病（AML）是一种恶性克隆且高度异质性的疾病。尽管AML的治疗给年轻患者带来了有希望的结果，但老年患者的预后仍然不佳。越来越有必要研究创新的治疗方案。
患者情况
我们报告一名86岁的AML患者，伴有发热、咳嗽和咳痰。
诊断
诊断为伴有成熟型的AML（AML-M2）及AML1/ETO。
干预措施
该患者接受高三尖杉酯碱联合三氧化二砷的治疗方案。
结果
该AML-M2伴AML1/ETO患者达到不完全缓解，但显示出很少的毒副作用且生存期延长。此外，我们分析了治疗期间全血细胞的动态计数。白细胞计数与原始细胞百分比呈正相关（r = 0.65），二者均与分叶核中性粒细胞百分比呈负相关（r = -0.63，-0.89）。
经验教训
高三尖杉酯碱和三氧化二砷可能诱导伴有AML1/ETO的AML-M2白血病细胞凋亡和分化。
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