Sato T, Wakabayashi Y, Kimura M, Kojima S, Hirasawa A, Sato T, Tashiro Y, Nishikawa T, Chiba S
Department of Internal medicine, Yokohama Rosai Hospital for Labor Welfare Corporation.
Rinsho Ketsueki. 1993 Feb;34(2):200-6.
Although aplastic anemia (AA) is well known to precede acute leukemia, commonly acute myeloblastic leukemia, an adult case of acute lymphoblastic leukemia (ALL) preceded by aplasia similar to severe AA is very rare. An 18-year-old female was admitted to our hospital for scrutiny of pancytopenia in October 3, 1991. She was diagnosed as severe AA because of severe bone marrow hypoplasia and no abnormal or dysplastic cell. Recovery of hematopoiesis was achieved by pulse therapy of methylprednisolone combined with granulocyte colony stimulating factor (G-CSF). 3 months after AA onset, she was readmitted because of high fever and paralytic ileus. Then, she was diagnosed as ALL (L1; common ALL) and was successfully treated by remission induction chemotherapy. Retrospectively, this case was atypical AA with respect to serum iron and LDH level.
虽然再生障碍性贫血（AA）先于急性白血病，通常是急性髓细胞白血病，这一点广为人知，但1例类似严重再生障碍性贫血的全血细胞减少先于急性淋巴细胞白血病（ALL）的成年病例非常罕见。一名18岁女性于1991年10月3日因全血细胞减少症入院接受检查。由于严重的骨髓发育不全且无异常或发育异常细胞，她被诊断为严重再生障碍性贫血。通过甲泼尼龙联合粒细胞集落刺激因子（G-CSF）的脉冲治疗实现了造血恢复。再生障碍性贫血发病3个月后，她因高热和麻痹性肠梗阻再次入院。随后，她被诊断为ALL（L1；普通ALL），并通过缓解诱导化疗成功治疗。回顾性分析，该病例在血清铁和乳酸脱氢酶水平方面属于非典型再生障碍性贫血。
