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骨肉瘤继发白血病极其少见;继发性白血病伴有t(8;21)者也属罕见。作者报道一例接受过放疗和化疗的骨肉瘤患者十年后发生急性粒细胞白血病(AML)且有t(8;21)异常。患者女性,24岁时因右股骨远端肿瘤就诊。骨经活检证实为骨肉瘤。经总剂量为500拉德放疗及化疗后肿瘤消失,未再复发。10年后因呼吸困难和皮肤青肿再次入院。此时有贫血和血小板减少,外周血出现原始细胞42%,骨髓象揭泵为AML-M_2。染色体检查发现20个细胞均有t(8;21)(q22;q22)和一个X染色体丢失,其中3个细胞还有9号单体和一个标记染色体。患者化疗后12个月才获完全缓解,并在异基因骨髓移植后不久死于巨细胞病毒性肺炎。
Osteosarcoma secondary leukemia is extremely rare; secondary leukemia associated with t (8; 21) are rare. The authors report that one patient with osteosarcoma who received radiotherapy and chemotherapy developed acute myeloid leukemia (AML) ten years later and had an abnormal t (8; 21). Female patient, 24 years old due to distal femoral tumor treatment. Bone biopsy confirmed osteosarcoma. The total dose of 500 Radian radiotherapy and chemotherapy after the tumor disappeared, no recurrence. After 10 years due to respiratory difficulties and skin re-admitted to hospital. There anemia and thrombocytopenia at this time, peripheral blood 42% of primitive cells, bone marrow Jie Jie pump as AML-M_2. Chromosome examination revealed that all 20 cells had t (8; 21) (q22; q22) and one X chromosome was lost. Three of the cells also contained a single chromosome 9 and a single marker chromosome. Patients were completely relieved 12 months after chemotherapy and died of cytomegalovirus pneumonia shortly after allogeneic bone marrow transplantation.