症例報告: 慢性リンパ球性白血病とマクロフォーカル多発性骨髄腫の同時発生,外メデュラー性プラズマ細胞腫
Yingming Jin1, Shuyan Wang2, Zhi Fang1
1Department of Hematology and Oncology, Ningbo No.2 Hospital, Ningbo, China.
Frontiers in oncology
|February 13, 2026
まとめ
この症例報告は,異例の慢性リンパ球性白血病 (CLL) とマクロフォーカル多発性骨髄腫 (MFMM) が並行して発生し,外メデュラー性プラズマ細胞腫として発現した症例を詳細に記載しています. 患者は,これらの血液学的悪性腫瘍に対する初期治療に完全な反応を達成しました.
科学分野:
- 血液学 ヘマトロジ
- 腫瘍学 腫瘍学
- 臨床症例報告 臨床症例報告
背景:
- 同時に発生する多発性骨髄腫 (MM) と慢性リンパ球性白血病 (CLL) は,極めてまれな血液学的悪性腫瘍である.
- マクロフォーカルMM (MFMM) とCLLの同時発生は,以前は外メデュラー性プラズマ細胞腫 (EMP) として報告されていなかった.
研究 の 目的:
- EMPと同時進行中のCLLとMFMMのユニークなケースをドキュメントする.
- この珍しい二重診断の診断方法と治療結果を記述する.
主な方法:
- 67歳の男性に腰痛と白血球数が増加した.
- 診断作業には,ポジトロン放出トモグラフィー/コンピュータトモグラフィー (PET/CT) スキャン,骨髄抽出,リンパ節生検が含まれていました.
- 病理学的分析により,プラズマサイトーマおよび新生性Bリンパ球による浸透が確認されました.
主要な成果:
- 最終診断:マクロフォーカル多発性骨髄腫 (MFMM) と慢性リンパ球性白血病 (CLL) の同時進行.
- ボルテゾミブ,レナリドミド,デキサメタゾンによる初期治療は完全回復をもたらした.
- 治療は,外周感覚神経病変のためにダラトゥミュマブとデキサメタゾンに変更されました.
結論:
- このケースは,同期的なCLLとMFMMがEMPとして提示される最初の文書化された事例を表しています.
- 患者は最初の治療に完全な反応を達成し,このまれな状態に対する効果的な治療戦略を強調しました.
- 治療の成功管理には,治療に起因する有害事象に基づいて治療の適応を伴うほか,継続的な外来追跡も行われました.
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