Xu Neng-Wen, Li Lin-Jie
Department of Hematology, College of Medicine, Lishui Hospital, Zhejiang University, Lishui 323000, Zhejiang Province, China.
World J Clin Cases. 2022 Oct 16;10(29):10655-10662. doi: 10.12998/wjcc.v10.i29.10655.
BCR-ABL-negative myeloproliferative neoplasms (MPNs) are clonal hematopoietic stem cell disorders characterized by the proliferation of one or more myeloid lineages and by mutually exclusive JAK2 V617F, CALR, and MPL[A1] mutations. The combination of MPN and thalassemia is extremely unusual. Several cases with myeloproliferative neoplasms and β-thalassemia have been reported. However, these have not been extensively reviewed. The present report describes two cases of myeloproliferative neoplasms complicated with β-thalassemia and reviews all similar cases reported in the literature.
We report two patients who were diagnosed with myeloproliferative neoplasms complicated with β-thalassemia. Both patients had abnormal increases in platelet counts. Based on bone marrow pathology and molecular biology assessment, we made the diagnosis of myeloproliferative neoplasms complicated with β-thalassemia. The female patient was given hydroxyurea and interferon, which enabled good control of her blood counts; the male patient was given ruxolitinib tablets, thalidomide tablets, and interferon to control the condition, but the patient poorly responded to drug treatment and died of gastrointestinal bleeding six months later.
Given the findings of our cases and the literature review, we hypothesize that myeloproliferative neoplasms complicated with β-thalassemia can lead to rapid disease progression and a poor prognosis.
BCR-ABL阴性骨髓增殖性肿瘤(MPNs)是克隆性造血干细胞疾病,其特征为一个或多个髓系谱系增殖,并伴有相互排斥的JAK2 V617F、CALR和MPL[A1]突变。MPN与地中海贫血的合并极为罕见。已有数例骨髓增殖性肿瘤合并β地中海贫血的病例报道。然而,这些病例尚未得到广泛综述。本报告描述了2例骨髓增殖性肿瘤合并β地中海贫血的病例,并对文献中报道的所有类似病例进行了综述。
我们报告了2例被诊断为骨髓增殖性肿瘤合并β地中海贫血的患者。两名患者的血小板计数均异常升高。基于骨髓病理学和分子生物学评估,我们做出了骨髓增殖性肿瘤合并β地中海贫血的诊断。女性患者接受了羟基脲和干扰素治疗,血细胞计数得到了良好控制;男性患者接受了芦可替尼片、沙利度胺片和干扰素治疗以控制病情,但患者对药物治疗反应不佳,6个月后死于胃肠道出血。
根据我们的病例发现和文献综述,我们推测骨髓增殖性肿瘤合并β地中海贫血可导致疾病快速进展和预后不良。