Hasegawa A, Ninomiya H, Yanagisawa K, Takada K, Hasegawa H, Hato T, Yasukawa M, Fujita S
First Department of Internal Medicine, Ehime University, School of Medicine.
Rinsho Ketsueki. 1996 Sep;37(9):853-7.
A 57-year-old woman was diagnosed as having non-Hodgkin lymphoma (follicular mixed cell, B-cell type, Stage III) in February 1988. Since then, she had been treated with radiation and chemotherapy contained with alkylating agents and etoposide for 6 years. In April 1994, peripheral blood study disclosed leukocytosis with basophilia and thrombocytosis. Bone marrow was hypercellular. The karyotype of bone marrow cells was 46, XX, t(9:22) (q34:q11). Rearrangement of bcr was detected in bone marrow, but not in lymph node cells. On the basis of these findings, she was diagnosed as having the chronic phase of chronic myelogenous leukemia (CML) following the therapy for malignant lymphoma and treated with interferon-alpha (IFN-alpha) and hydroxycarbamide. Following this therapy, the lymphoadenopathy promptly disappeared and chromosome analysis showed disappearance of Ph chromosome positive cells. Although CML is rare in secondary leukemia, the present case seemed therapy-related CML and the treatment with IFN-alpha and hydroxycarbamide was effective for both CML and malignant lymphoma.
一名57岁女性于1988年2月被诊断为非霍奇金淋巴瘤（滤泡混合型，B细胞型，Ⅲ期）。从那时起，她接受了6年的放疗以及含有烷化剂和依托泊苷的化疗。1994年4月，外周血检查发现白细胞增多伴嗜碱性粒细胞增多和血小板增多。骨髓细胞增多。骨髓细胞的核型为46, XX, t(9;22)(q34;q11)。在骨髓中检测到bcr重排，但在淋巴结细胞中未检测到。基于这些发现，她被诊断为在恶性淋巴瘤治疗后进入慢性粒细胞白血病（CML）慢性期，并接受了α干扰素（IFN-α）和羟基脲治疗。经过该治疗后，淋巴结肿大迅速消失，染色体分析显示Ph染色体阳性细胞消失。虽然CML在继发性白血病中很少见，但本病例似乎是治疗相关的CML，且IFN-α和羟基脲治疗对CML和恶性淋巴瘤均有效。
