Ono Y, Ito S, Murai K, Miyairi Y, Enomoto S, Kaneko J, Sugawara T, Numaoka H, Shimosegawa K, Utsugisawa T, Narigasawa Y, Ito T, Ishida Y, Kuriya S
Hematology Division, School of Medicine Iwate Medical University, Morioka Japan.
Rinsho Ketsueki. 1997 Jan;38(1):41-6.
We report a case of 53-year-old man with acute myelogenous leukemia (M2) showing a karyotype of t(7;11) (p15;p15), del(10) (q11;q12), who was complicated with perforation of a duodenal ulcer during the antileukemic chemotherapy using behenoyl ara-C, daunorubicin, 6-mercaptopurine and prednisolone. As his bone marrow still showed high cell density and leukemic proliferation at the time of intestinal perforation, the therapeutic regimen was changed to a combination of behenoyl are-C and mitoxantrone, and daily rhG-CSF was concurrently administered for the purpose of early establishment of bone marrow hypoplasia. On the 8th day after the therapeutic regimen had been changed, his bone marrow became nearly aplastic, and complete remission was obtained on the 24th day. This case may indicate that the concurrent administration of cell-cycle specific antileukemic drugs and rhG-CSF is available for AML patients with emergent need of leukemic cell reduction.
我们报告一例53岁男性急性髓性白血病（M2）患者，其核型为t(7;11) (p15;p15)，del(10) (q11;q12)，在使用山嵛酰阿糖胞苷、柔红霉素、6-巯基嘌呤和泼尼松龙进行抗白血病化疗期间并发十二指肠溃疡穿孔。由于在肠道穿孔时其骨髓仍显示高细胞密度和白血病增殖，治疗方案改为山嵛酰阿糖胞苷与米托蒽醌联合使用，并同时每日给予重组人粒细胞集落刺激因子（rhG-CSF）以尽早实现骨髓造血功能低下。在治疗方案改变后的第8天，其骨髓几乎呈再生障碍状态，并在第24天获得完全缓解。该病例可能表明，对于急需减少白血病细胞的急性髓性白血病患者，联合使用细胞周期特异性抗白血病药物和rhG-CSF是可行的。
