Yamada Shinya, Arita Kotaro, Kondo Yukio, Mizuta Shuichi, Okumura Hirokazu
Department of Hematology, Toyama Prefectural Central Hospital, Toyama, Japan.
Department of Hematology and Immunology, Kanazawa Medical University Hospital, Kanazawa, Japan.
Case Rep Oncol. 2022 May 16;15(2):535-540. doi: 10.1159/000524770. eCollection 2022 May-Aug.
Chronic myeloid leukemia (CML) blast phase (monocytic lineage) is extremely rare. A 39-year-old Japanese man was diagnosed with CML blast phase (monocytic lineage). T315I mutation was positive, ponatinib was initially started, and then, allogenic hematopoietic stem cell transplantation (allo-HSCT) was performed. Seven days after allo-HSCT, hyper-acute graft-versus-host disease developed, and medial temporal lobe encephalitis emerged 24 days after allo-HSCT. He was alive for over 1 year after allo-HSCT. This is the first case report of HSCT for CML blast phase (monocytic lineage) in tyrosine kinase inhibitor era. Further cases should be documented for effective treatment regimen and analysis of clinical features.
慢性髓性白血病（CML）急变期（单核细胞系）极为罕见。一名39岁的日本男性被诊断为CML急变期（单核细胞系）。T315I突变呈阳性，最初开始使用波纳替尼治疗，随后进行了异基因造血干细胞移植（allo-HSCT）。allo-HSCT后7天发生了超急性移植物抗宿主病，allo-HSCT后24天出现了内侧颞叶脑炎。allo-HSCT后他存活了1年多。这是酪氨酸激酶抑制剂时代CML急变期（单核细胞系）HSCT的首例病例报告。应记录更多病例以制定有效的治疗方案并分析临床特征。
