仅以血小板增多为首发表现的慢性粒细胞白血病5例临床分析

彭树弈; 梁晔; 罗琳; 刘练金; 李忠清; 赖颖晖; 刘振芳; 彭志刚; 赖永榕; 罗军

doi:10.13201/j.issn.1004-2806.2015.09.006

仅以血小板增多为首发表现的慢性粒细胞白血病5例临床分析

- 1 广西医科大学第一附属医院血液科(南宁, 530021)

详细信息

通讯作者: 罗军,E-mail:luojungz@medmail.com.cn

中图分类号: R733.72

收稿日期: 2015-02-09

Clinical study on 5cases of chronic myelogenous leukemia with thrombocythemia onset

- Department of Hematology, the First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, China

More Information

Corresponding author: LUO Jun, E-mail: luojungz@medmail.com.cn

Received Date: 09 February 2015

摘要

摘要: 目的:探讨仅以血小板增多为首发而没有典型慢性粒细胞白血病(CML)表现的5例患者的临床诊断及治疗效果。方法:回顾性分析5例仅以血小板增多为首发表现的CML患者的临床资料。结果:5例患者均仅以血小板增多为首发表现,均无肝脾肿大;血小板均>1 000×10⁹/L,白细胞计数及分类正常;骨髓细胞学示巨核细胞明显增多,粒系增生正常,NAP积分正常或增加;患者均有Ph染色体和BCR-ABL融合基因;患者均使用伊马替尼治疗,4例在12个月内达到完全分子学反应。结论:仅以血小板增多为首发表现的患者,如缺乏典型CML的临床表现,易误诊为原发性血小板增多症,应作Ph染色体及BCR-ABL融合基因检测以鉴别;这些患者给予伊马替尼治疗取得很好的疗效,可能是CML的发病早期。
- 血小板增多 /
- 慢性粒细胞白血病 /
- Ph染色体 /
- BCR-ABL融合基因
Abstract: Objective:To evaluate the diagnosis and therapeutic effect of chronic myelogenous leukemia (CML) with thrombocythemia onset.Method:The clinical manifestations,laboratory features,and treatment in 5 cases of CML with thrombocythemia onset were analyzed retrospectively.Result:All patients were only thrombocythemia onset,and splenomegaly was not present in all cases.Platelet significantly increased (>1000×10⁹/L),white-cell count and differential count were normal.The megakaryocyte increased obviously,granulopoiesis and maturation were normal,neutrophil alkaline phosphatase was normal or slight increased in bone marrow.Ph chromosome and BCR-ABL fusion gene were present in all cases.All patients were treated with imatinib,4 cases achieved complete molecular response within 12 months.Conclusion:CML with thrombocythemia onset,while lack of classic clinical features of CML,is easily misdiagnosed as essential thrombocythemia and should be detected Ph chromosome and BCR-ABL fusion gene.These observations indicated CML with thrombocythemia onset can be regarded as early manifestations of the chronic stable phase.
- thrombocythemia /
- chronic myelogenous leukaemia /
- Philadelphia chromosome /
- BCR-ABL fusion gene

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参考文献(10)

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