Ichikawa Satoshi, Abe Hiroaki, Komatsu Hiroka, Takenaka Kenta, Nakamura Hiroshi, Morota Naoya, Sakurai Kazuki, Kawajiri Akihisa, Nakagawa Ryo, Inokura Kyoko, Onodera Koichi, Onishi Yasushi, Fukuhara Noriko, Yokoyama Hisayuki, Harigae Hideo
Department of Hematology, Tohoku University Hospital, Japan.
Department of Hematology and Rheumatology, Tohoku Medical and Pharmaceutical University Hospital, Japan.
Intern Med. 2025 Apr 15;64(8):1235-1239. doi: 10.2169/internalmedicine.4221-24. Epub 2024 Sep 27.
A 21-year-old man was diagnosed with myeloid/natural killer precursor leukemia (MNKPL) with bone marrow infiltration of blasts of cyCD3, CD7, CD33, CD34, CD56, HLA-DR, cyMPO, and TdT immunophenotypes. Although hyper-hyperfractionated cyclophosphamide, doxorubicin, vincristine, dexamethasone therapy was unsuccessful, induction treatment with idarubicin and cytarabine resulted in complete remission (CR). The patient subsequently underwent cord blood transplantation with a myeloablative conditioning regimen, which resulted in durable CR and complete donor chimerism. He had been in good health without relapse for over nine months since transplantation. Timely allogeneic hematopoietic stem cell transplantation using an available donor source may be a promising treatment strategy for MNKPL.
一名21岁男性被诊断为髓系/自然杀伤前体白血病（MNKPL），其骨髓中有细胞周期蛋白依赖性激酶3（cyCD3）、CD7、CD33、CD34、CD56、人类白细胞抗原-DR（HLA-DR）、细胞质髓过氧化物酶（cyMPO）和末端脱氧核苷酸转移酶（TdT）免疫表型的原始细胞浸润。尽管超大剂量环磷酰胺、阿霉素、长春新碱、地塞米松治疗未成功，但伊达比星和阿糖胞苷诱导治疗导致完全缓解（CR）。患者随后接受了采用清髓性预处理方案的脐血移植，结果实现了持久的CR和完全供体嵌合。自移植以来，他健康状况良好，九个多月未复发。使用可用供体来源及时进行异基因造血干细胞移植可能是MNKPL的一种有前景的治疗策略。
