病例报告:BCR-ABL阳性急性淋巴细胞白血病与骨破坏:一个治疗困境
Shi Lijun1, Ma Zhongrui2,3, Wei Li1
1Department of Hematology, Chengdu Fifth People's Hospital, Chengdu, China.
Frontiers in oncology
|March 7, 2024
概括
这项研究详细介绍了一例罕见的BCR-ABL阳性急性淋巴细胞白血病 (ALL) 的成年病例,该病例表现为骨破坏和高血症. 有效控制这种侵袭性白血病亚型仍然是一个挑战,需要新的治疗策略.
科学领域:
- 血液学 血液学 血液学
- 在瘤学瘤学.
- 遗传学 遗传学 是一个
背景情况:
- BCR-ABL阳性急性淋巴细胞白血病 (ALL) 是一个独特的亚型.
- 骨损伤和高血是成年人罕见的初始症状.
研究的目的:
- 报告一种罕见的BCR-ABL阳性ALL病例,具有特定的遗传突变 (三倍体型,WT1,CDKN2A),呈现高血症和骨破坏.
- 讨论管理这种侵袭性白血病形式的挑战.
主要方法:
- 病例报告详细说明了临床表现,诊断工作和治疗过程.
- 基因分析包括型和突变分析 (WT1,CDKN2A,BCR-ABL).
- 治疗包括诱导化疗,达沙替尼布,VMCP,奥雷巴替尼布和VP疗法.
主要成果:
- 最初通过诱导化疗实现完全缓解 (CR).
- 在达沙替尼后,尽管BCR-ABL阴性,但仍有广泛的骨破坏.
- 发生了白血病复发,BCR-ABL阳性和T315I突变.
- 通过OREBATINIB和VP后胆囊炎手术实现CR2.
- 患者最终因严重的肺部感染而死亡.
结论:
- 具有骨损伤的BCR-ABL阳性ALL在成年人中是一种罕见且具有挑战性的临床实体.
- 单独的氨酸激酶抑制剂化疗可能不足以控制这种侵略性的亚型.
- 进一步研究更有效的治疗方式至关重要.
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