论文部分内容阅读
病例女性,50岁。疲乏6个月,体重减轻24磅。肝中等肿大(上下径15厘米),脾巨大(上下径24厘米)。实验室检查:血红蛋白114g/L,红细胞压积39%,白细胞237×10~9/L,分类示原粒2%、早幼粒8%、中幼粒23%、晚幼粒14%、杆核22%、分叶29%、淋巴1%、单核1%,血小板732×10~9/L。白细胞碱性磷酸酶积分0。髓象示慢性粒细胞白血病(CML),Ph~1染色体阳性,诊断CML。应用马利兰每日6毫克和别嘌呤醇100毫克每日3次,以后马利兰的用量根据血象调整。1年7个月后,发生全血细胞减少。髓象示中度增生,粒红比值倒置(1∶2),红系占61%,并有发育成熟障碍,贮铁增加,非环形铁粒幼细胞51%,环形铁粒幼细胞20%。停马利兰,采用达
Case female, 50 years old. Tired for 6 months, weight loss 24 pounds. Medium liver enlargement (up and down diameter 15 cm), splenomegaly (up and down diameter 24 cm). Laboratory tests: hemoglobin 114g / L, hematocrit 39%, white blood cells 237 × 10 ~ 9 / L, the classification shows 2% of the original particles, promyelocytic 8%, 23% 22% nuclear, 29% leaf, lymphoid 1%, monocytic 1%, platelet 732 × 10 ~ 9 / L. Leukocyte alkaline phosphatase score 0. Myelogram showed chronic myeloid leukemia (CML), Ph ~ 1 chromosome positive, the diagnosis of CML. Application of Maryland daily 6 mg and allopurinol 100 mg 3 times a day, after the amount of Maryland according to the blood to adjust. After 1 year and 7 months, pancytopenia occurs. The medulla shows moderate hyperplasia, with a ratio of granule to erythematous upside down (1: 2), with erythroid accounting for 61%, with developmental maturation disorder, increased storage of iron, 51% of noncircular keratinocytes, and 20% of annular keratinocytes. Stop Maryland, using up