骨髓肉瘤作为晚期孤立中枢神经系统复发骨髓移植后复发的表现特征
Amiya Ranjan Nayak1, K V Vinu Balraam1, Jasmita Dass1
1Department of Hematology, All India Institute of Medical Sciences, New Delhi, India.
概括
在移植后的急性髓性白血病 (AML) 患者中,孤立的中枢神经系统 (CNS) 复发是罕见的. 这种情况强调在高血压后对中枢神经系统症状的监测,即使没有骨髓参与.
科学领域:
- 血液学 血液学 血液学
- 神经学 神经学
- 在瘤学瘤学.
背景情况:
- 接受全源造血干细胞移植 (HSCT) 的急性髓性白血病 (AML) 患者面临中枢神经系统 (CNS) 复发的罕见风险.
- 移植后的中枢神经系统复发可以潜伏地出现,即使骨髓仍然没有疾病.
研究的目的:
- 在HSCT后的AML中报告一个罕见的中枢神经系统复发病例.
- 强调在移植后对AML患者进行警的中枢神经系统监测的重要性.
主要方法:
- 在HSCT5年后,一个中等风险AML患者的病例介绍.
- 诊断工作包括神经成像,脑脊液 (CSF) 通过流动细胞计免疫表型 (FCM IPT) 和细胞形态学分析.
- 进行骨髓检查以排除系统性复发.
主要成果:
- 图像检查显示,大脑膜中有一个大,均增强的病变.
- 脑脊髓分析证实了单独的中枢神经系统复发,没有证据表明骨髓参与.
- 通过FCM IPT和CSF的细胞形态学来确立诊断.
结论:
- 孤立的中枢神经系统复发可能发生在AML患者几年后HSCT.
- 在移植后的AML治疗中,对神经症状的积极监测至关重要.
- 通过CSF分析进行早期检测是中枢神经系统复发的及时干预的关键.
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