Department of Hematology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, 300381, China.
National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, 300381, China.
BMC Geriatr. 2024 Jul 11;24(1):595. doi: 10.1186/s12877-024-05196-7.
Atypical chronic myeloid leukemia (aCML) is a highly aggressive type of blood cancer that falls under the category of myelodysplastic/myeloproliferative neoplasms (MDS/MPN). In the fifth edition of the WHO classification of tumors, this category has been renamed MDS/MPN with neutrophilia. Although eosinophilia is commonly observed in blood cancers, it is rarely seen in aCML.
This study presents a case of aCML that was diagnosed six years after the patient developed eosinophilia. The patient had undergone tests to rule out other primary and secondary diseases, but the eosinophilia remained unexplained. Treatment with corticosteroids and hydroxyurea had proven ineffective. Six years later, the patient experienced an increase in white blood cells, primarily neutrophils. After ruling out other possible diagnoses, a combination of morphologic and molecular genetic findings led to the diagnosis of aCML. The patient responded well to treatment with azacitidine.
This study summarizes the current state of aCML diagnosis and management and discusses the possible connection between eosinophilia and aCML.
非典型慢性髓性白血病（aCML）是一种高度侵袭性的血液癌，属于骨髓增生异常/骨髓增殖性肿瘤（MDS/MPN）。在世界卫生组织第五版肿瘤分类中，这一类已更名为伴嗜中性粒细胞增多的 MDS/MPN。虽然嗜酸性粒细胞增多症在血液癌中很常见，但在 aCML 中很少见。
本研究报告了一例 aCML 病例，该病例在患者出现嗜酸性粒细胞增多六年后被诊断出。患者已接受检查以排除其他原发性和继发性疾病，但嗜酸性粒细胞增多仍无法解释。皮质类固醇和羟基脲治疗均无效。六年后，患者的白细胞增多，主要是中性粒细胞。在排除其他可能的诊断后，形态学和分子遗传学发现的结合导致了 aCML 的诊断。患者对阿扎胞苷治疗反应良好。
本研究总结了 aCML 的诊断和治疗现状，并讨论了嗜酸性粒细胞增多与 aCML 之间的可能联系。
