Department of Hematology, HangZhou Red Cross Hospital, Hangzhou, Zhejiang, China.
J Int Med Res. 2020 May;48(5):300060520920395. doi: 10.1177/0300060520920395.
A 60-year-old male patient presented with a serum α-fetoprotein (AFP) level of 2940.5 ng/mL accompanied by a significant increase in serum globulin. Hepatitis B virus (HBV) DNA was 2.85 × 10 (normal value <1.0 × 10). B-mode ultrasound and magnetic resonance imaging showed characteristic manifestations and he was clinically diagnosed with hepatocellular carcinoma in January 2015. He received radiofrequency ablation and tenofovir disoproxil anti-HBV therapy and his serum AFP and globulin levels were significantly reduced. In March 2018, he presented at our Hematology Department with fatigue and a pale complexion. At that time, his serum AFP level was normal, with hemoglobin 61 g/L and globulin 64.7 g/L. He was diagnosed with multiple myeloma (MM) by bone marrow examination, and immunofixation electrophoresis. The patient received PCD chemotherapy (bortezomib 2.0 g/dL on days 1, 4, 8, and 11 plus cyclophosphamide 0.3 g/dL on days 1-4 plus dexamethasone 20 mg/dL on days 1-2, 4-5, 8-9, and 11-12). The patient finally died of MM complicated by disseminated intravascular coagulation.
一位 60 岁男性患者的血清甲胎蛋白（AFP）水平为 2940.5ng/ml，同时血清球蛋白显著升高。乙肝病毒（HBV）DNA 为 2.85×10（正常值 <1.0×10）。B 型超声和磁共振成像显示出特征性表现，临床诊断为 2015 年 1 月肝细胞癌。他接受了射频消融和替诺福韦二吡呋酯抗 HBV 治疗，血清 AFP 和球蛋白水平显著降低。2018 年 3 月，他因疲劳和面色苍白到我院血液科就诊。当时，他的血清 AFP 水平正常，血红蛋白 61g/L，球蛋白 64.7g/L。骨髓检查和免疫固定电泳诊断为多发性骨髓瘤（MM）。患者接受 PCD 化疗（硼替佐米 2.0g/dL，第 1、4、8 和 11 天，环磷酰胺 0.3g/dL，第 1-4 天，地塞米松 20mg/dL，第 1-2、4-5、8-9 和 11-12 天）。患者最终死于 MM 并发弥漫性血管内凝血。
