Perugini O, Montanari G, Nalli G
Divisione di Medicina I, Ospedale Maggiore di Lodi, Italy.
Haematologica. 1995 May-Jun;80(3):234-7.
We report a 72-year-old man with refractory anemia with excess of blasts who presented severe pancytopenia and pneumonia and received granulocyte colony-stimulating factor (G-CSF) treatment over a 6-week period. In addition to a dramatic increase in mature neutrophils, platelet count and hemoglobin level, the patient achieved a hematological remission which continued for more than 5 months despite discontinuation of the treatment. This observation confirms that in some cases during G-CSF treatment erythropoiesis and thrombopoiesis may improve in addition to the expected effect on neutrophils. While the patient remained in hematological remission, bone marrow examination revealed trilineage dysplasia. This finding suggests that the hematological remission in this patient may not have resulted from a recovery of non-clonal hematopoiesis of a normal clone, but may have derived instead from the monoclonal hematopoiesis of a neoplastic clone.
我们报告了一名72岁患有伴原始细胞增多的难治性贫血患者，该患者出现严重全血细胞减少和肺炎，并在6周内接受了粒细胞集落刺激因子（G-CSF）治疗。除了成熟中性粒细胞、血小板计数和血红蛋白水平显著增加外，患者实现了血液学缓解，尽管停止治疗，但缓解持续了5个多月。这一观察结果证实，在G-CSF治疗期间的某些情况下，除了对中性粒细胞的预期作用外，红细胞生成和血小板生成也可能得到改善。虽然患者仍处于血液学缓解状态，但骨髓检查显示三系发育异常。这一发现表明，该患者的血液学缓解可能并非源于正常克隆的非克隆性造血恢复，而是可能源于肿瘤克隆的单克隆造血。
