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一名70岁女性患常见B细胞急性淋巴细胞白血病,在接受卡铂-紫杉烷放疗治疗子宫内膜癌两年后发病。

Common B-cell acute lymphoblastic leukaemia in a 70-year-old woman presenting 2 years after carboplatin-taxane radiotherapy for endometrial cancer.

作者信息

Murray Nigel P, Orrego Shenda, López Marco Antonio, Munoz Lorena, Minzer Simona

机构信息

Consultant Haematologist, Department of Medicine, Hospital de Carabineros de Chile, Simón Bolívar 2200, Ñuñoa, Santiago, 7770199, Chile.

Professor Haematology, Faculty of Medicine, University Finis Terrae, Av Pedro de Valdivia 1509, Providencia, Santiago.

出版信息

Ecancermedicalscience. 2019 Oct 29;13:972. doi: 10.3332/ecancer.2019.972. eCollection 2019.

Abstract

Therapy-related acute lymphoblastic leukaemia (t-ALL) is a poorly defined entity and is not featured in the World Health Organization classification as a distinct clinical entity from acute lymphoblastic leukaemia (ALL), thus differing from therapy-related acute myeloid leukaemia and myelodysplasia. We present a case of t-ALL occurring 18 months after treatment for metastatic endometrial cancer with a regimen of carboplatin, paclitaxel and radiotherapy. The patient presented with severe pancytopenia and diagnosed with common-B ALL, and the cytogenetic analysis showed a previously unreported deletion in chromosome 19 (q13.1) in 100% of the blast cells. The patient declined further therapy and died 1 month later. This rare but serious side effect of chemo-radiotherapy should be considered when deciding on treatment options for gynaecological cancers.

摘要

治疗相关急性淋巴细胞白血病(t-ALL)是一个定义不明确的实体,在世界卫生组织的分类中,它并非作为与急性淋巴细胞白血病(ALL)不同的独特临床实体出现,因此与治疗相关急性髓系白血病和骨髓增生异常不同。我们报告一例t-ALL病例,该病例发生在转移性子宫内膜癌接受卡铂、紫杉醇和放疗方案治疗18个月后。患者表现为严重全血细胞减少,诊断为普通B淋巴细胞白血病,细胞遗传学分析显示100%的原始细胞中存在19号染色体(q13.1)上一个此前未报告的缺失。患者拒绝进一步治疗,1个月后死亡。在决定妇科癌症的治疗方案时,应考虑这种罕见但严重的放化疗副作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4f78/6834386/5b3d6245671b/can-13-972fig1.jpg

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