Montemayor-Montoya J L, De León-Cantú R E, Gómez-Almaguer D, Herrera-Garza J L
Departamento de Medicina Interna, Hospital Universitario de la UANL, Monterrey, N.L., México.
Rev Invest Clin. 1997 Jul-Aug;49(4):295-8.
Bone marrow necrosis (BMN) is mostly diagnosed at postmortem examination. It has been observed in association with acute leukemia and other malignant diseases. We report here BMN in two patients with acute myeloid leukemia (AML) and one with acute lymphocytic leukemia (ALL) in whom the diagnosis was made while alive. Two patients died because of intracranial bleeding. One with AML (M5) developed BMN one week after he was treated with a second course of chemotherapy: he had a complete recovery and remains in remission almost five years after the diagnosis. We conclude that antemortem diagnosis of BMN is technically difficult, but as it is not always associated to a fatal prognosis, an early diagnosis and vigorous supportive therapy should be attempted.
骨髓坏死(BMN)大多在尸检时被诊断出来。它已被观察到与急性白血病和其他恶性疾病有关。我们在此报告两例急性髓系白血病(AML)患者和一例急性淋巴细胞白血病(ALL)患者的骨髓坏死情况,这三例患者均在生前被确诊。两名患者因颅内出血死亡。一名AML(M5)患者在接受第二个疗程化疗一周后发生了骨髓坏死:他完全康复,确诊后近五年仍处于缓解期。我们得出结论,骨髓坏死的生前诊断在技术上具有难度,但由于它并不总是与致命预后相关,因此应尝试进行早期诊断和积极的支持治疗。