Ji Lin, Yang Wei, Gao Liu Jie, Zhang Bei Yuan, Xu Ya Qing, Xu Xiao Feng
Department of Oncology and Hematology, Hangzhou Red Cross Hospital, Hangzhou, Zhejiang 310003, P.R. China.
Oncol Lett. 2024 Oct 11;28(6):601. doi: 10.3892/ol.2024.14734. eCollection 2024 Dec.
Patients with concurrent acute myeloid leukemia (AML) and active pulmonary tuberculosis (TB) exhibit certain characteristics; cough, phlegm, fever, hemoptysis, weight loss and dyspnea are common symptoms of both diseases. These patients often cannot tolerate traditional intensive chemotherapy regimens, and finding the optimal timing in the treatment of both AML and active pulmonary TB is complex. Neglecting timely treatment can lead to serious complications and even fatal outcomes. The present paper reports two cases of patients with AML who were diagnosed with active pulmonary TB. The patients received intensive anti-TB treatment with isoniazid, rifampicin, pyrazinamide and ethambutol for 10-15 days. After three consecutive negative sputum smears, the patients in cases 1 and 2 were treated with a venetoclax, homoharringtonine and cytarabine regimen; and a venetoclax and azacitidine regimen for anti-AML therapy, respectively, as well as individualized anti-TB regimens of isoniazid, pyrazinamide, ethambutol and quinolone. Subsequently, both patients achieved complete remission of AML and their active TB was well controlled.
同时患有急性髓系白血病（AML）和活动性肺结核（TB）的患者具有某些特征；咳嗽、咳痰、发热、咯血、体重减轻和呼吸困难是这两种疾病的常见症状。这些患者通常无法耐受传统的强化化疗方案，并且在AML和活动性肺结核的治疗中找到最佳时机很复杂。忽视及时治疗可能导致严重并发症甚至致命后果。本文报告了两例被诊断为活动性肺结核的AML患者。患者接受了异烟肼、利福平、吡嗪酰胺和乙胺丁醇的强化抗结核治疗10 - 15天。连续三次痰涂片阴性后，病例1和病例2的患者分别接受了维奈克拉、高三尖杉酯碱和阿糖胞苷方案；以及维奈克拉和阿扎胞苷方案进行抗AML治疗，同时接受异烟肼、吡嗪酰胺、乙胺丁醇和喹诺酮的个体化抗结核方案。随后，两名患者的AML均实现完全缓解，其活动性肺结核也得到良好控制。
