Zeng Yuqing, Yang Yuanyuan, Huang Jian, Liu Haitao, Quan Lina, Lan Xiuwen
Department of Critical Care Medicine, Harbin Medical University Cancer Hospital, 150 Haping Road, Harbin, 150081, China.
Department of Breast Medical Oncology, Harbin Medical University Cancer Hospital, 150 Haping Road, Harbin, 150081, China.
Virol J. 2025 Jun 12;22(1):193. doi: 10.1186/s12985-025-02798-4.
Aggressive NK-cell leukemia (ANKL) is a scarce mature NK-cell neoplasm frequently associated with Epstein-Barr virus (EBV) infection. We report the case of a 47-year-old male patient who was admitted to the hospital due to recurrent fever, jaundice, and dyspnea, and was diagnosed with ANKL accompanied by multi-organ failure. Upon transfer to the intensive care unit (ICU), he received emergency chemotherapy consisting of etoposide, pegaspargase, and gemcitabine, in conjunction with organ support therapies including DPMAS, LPE, and CVVHD. Subsequently, the patient’s condition stabilized, and he was discharged. However, following the second cycle of chemotherapy, he was readmitted due to altered mental status. Due to financial constraints, the family decided not to pursue further treatment, leading to the patient’s eventual demise. Overall, this case highlights the critical importance of multidisciplinary collaboration for managing critically ill ANKL patients. Careful evaluation of the risks associated with chemotherapy, combined with timely administration of emergency chemotherapy in the ICU and comprehensive multi-organ support, can potentially offer a survival opportunity.
侵袭性NK细胞白血病（ANKL）是一种罕见的成熟NK细胞肿瘤，常与爱泼斯坦-巴尔病毒（EBV）感染相关。我们报告一例47岁男性患者，因反复发热、黄疸和呼吸困难入院，被诊断为ANKL并伴有多器官功能衰竭。转入重症监护病房（ICU）后，他接受了由依托泊苷、聚乙二醇天冬酰胺酶和吉西他滨组成的紧急化疗，同时接受了包括双重血浆分子吸附系统（DPMAS）、脂蛋白置换（LPE）和连续性静脉-静脉血液滤过透析（CVVHD）在内的器官支持治疗。随后，患者病情稳定并出院。然而，在第二个化疗周期后，他因精神状态改变再次入院。由于经济限制，家属决定不再寻求进一步治疗，导致患者最终死亡。总体而言，该病例突出了多学科协作对管理重症ANKL患者的至关重要性。仔细评估化疗相关风险，结合在ICU及时给予紧急化疗和全面的多器官支持，可能会提供生存机会。
