Klenn P J, Hyun B H, Lee Y H, Zheng W Y
Department of Pathology and Cell Biology, Thomas Jefferson University Hospital, Philadelphia, PA 19107.
Yonsei Med J. 1993 Sep;34(3):293-300. doi: 10.3349/ymj.1993.34.3.293.
This is the case of a 71 year old male who developed multiple myeloma (MM) and chronic myelogenous leukemia (CML) within a two year period. The patient initially presented with osteolytic lesions of the lumbar spine, and following the initial work-up a diagnosis of multiple myeloma with an IgG kappa paraproteinemia was made and appropriate treatment was given. Two years later the patient developed a progressively worsening leukocytosis which was found to be due to Philadelphia Chromosome (Ph1) positive CML. The occurrence in the same patient of two distinct hematologic malignancies suggests a neoplastic transformation of a pluripotent stem cell. A review of the literature appears to support the existence of a relationship between MM and CML as well as a relationship between MM and the myeloproliferative disorders.
这是一名71岁男性的病例，他在两年内先后患上了多发性骨髓瘤（MM）和慢性粒细胞白血病（CML）。患者最初表现为腰椎溶骨性病变，经过初步检查后诊断为多发性骨髓瘤伴IgG κ副蛋白血症，并给予了适当治疗。两年后，患者出现进行性加重的白细胞增多症，经检查发现是由费城染色体（Ph1）阳性的慢性粒细胞白血病引起的。同一患者发生两种不同的血液系统恶性肿瘤，提示多能干细胞发生了肿瘤转化。文献综述似乎支持多发性骨髓瘤与慢性粒细胞白血病之间存在关联，以及多发性骨髓瘤与骨髓增殖性疾病之间存在关联。
