Shammas F, Meyer P, Heikkila R, Apeland T, Gøransson L, Berland J, Kjellevold K
Department of Medicine, Central Hospital In Rogaland, Stavanger, Norway.
Acta Haematol. 1997;97(3):184-6. doi: 10.1159/000203678.
We describe the case of a 57-year-old woman with chronic myelogenous leukemia who was on hydroxyurea and developed a fatal thrombotic microangiopathy with renal, retinal and central nervous system involvement. There was no evidence of medullary or extramedullary leukemia transformation. Repeated examinations of the peripheral blood film revealed only minimal morphological changes of microangiopathic hemolysis. The diagnosis was made by postmortem examination of the kidneys, brain, meninges and retina. The underlying etiology may have been a paraneoplastic phenomenon of the chronic phase of CML or may have indicated the beginning of transformation to an accelerated phase. A late side effect of hydroxyurea therapy cannot be excluded.
我们报告了一例57岁慢性粒细胞白血病女性患者的病例，该患者正在接受羟基脲治疗，并发了致命的血栓性微血管病，累及肾脏、视网膜和中枢神经系统。没有证据表明存在髓系或髓外白血病转化。多次外周血涂片检查仅发现微血管病性溶血的轻微形态学改变。诊断通过对肾脏、大脑、脑膜和视网膜进行尸检得出。潜在病因可能是慢性粒细胞白血病慢性期的副肿瘤现象，也可能表明已开始向加速期转化。不能排除羟基脲治疗的晚期副作用。
