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急性未分化白血病合并未分化髓系肉瘤:病例报告及文献复习

Acute undifferentiated leukemia with undifferentiated myeloid sarcoma: Case report and literature review.

作者信息

Luo Lan, Wang Xiaoqing, Luo Ji, Zheng Shuai, Gong Ninghan, He Yuan, Xi Qian, Chen Jiao, Jiang Tao, Zhong Ling

机构信息

College of Medical Technology, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.

Department of Hematology, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, School of medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan Province, China.

出版信息

Medicine (Baltimore). 2024 Jan 26;103(4):e36948. doi: 10.1097/MD.0000000000036948.

Abstract

BACKGROUND

With the advancement of diagnostic technology, true acute undifferentiated leukemia (AUL) is becoming more rare, and AUL with extramedullary sarcoma has not been reported.

CASE PRESENTATION

This article reports a case of AUL with extramedullary sarcoma. Flow cytometric analysis of the bone marrow and lymph nodes indicated that the tumor cells of both were of the same origin and mainly expressed stem cell markers and CD7, no myeloid-specific markers, T-lymphoblastic-related markers, and B-lymphoblastic-related markers. Although the priming regimen combined with azacitidine was ineffective, complete remission was achieved by switching to azacitidine combined with HIA (homoharringtonine, idarubicin plus Ara-C).

CONCLUSION

To diagnosis de novo acute leukemia with extensive and comprehensive cellular immune maker detection is available and credible, the expression of a single relatively nonspecific myeloid antigen as a immune maker to detect AUL or AUL associated with sarcoma is precise and effective in our case, which patient was benefit from HIA regiment.

摘要

背景

随着诊断技术的进步,真正的急性未分化白血病(AUL)越来越罕见,且尚未有关于伴有髓外肉瘤的AUL的报道。

病例报告

本文报告1例伴有髓外肉瘤的AUL。对骨髓和淋巴结进行流式细胞术分析表明,两者的肿瘤细胞起源相同,主要表达干细胞标志物和CD7,无髓系特异性标志物、T淋巴母细胞相关标志物及B淋巴母细胞相关标志物。尽管联合阿扎胞苷的诱导方案无效,但换用阿扎胞苷联合HIA(高三尖杉酯碱、伊达比星加阿糖胞苷)后实现了完全缓解。

结论

通过广泛而全面的细胞免疫标志物检测来诊断初发急性白血病是可行且可靠的,在我们的病例中,将单一相对非特异性的髓系抗原表达作为免疫标志物来检测AUL或与肉瘤相关的AUL是准确有效的,该患者从HIA方案中获益。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/46f9/10817018/6c257304b4be/medi-103-e36948-g001.jpg

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