Hypereosinophilic syndromeの診断から12年後に発症したCD19陽性acute myeloblastic leukemia CD19-positive acute myeloblastic leukemia developed 12 years after the onset of hypereosinophilic syndrome

この論文にアクセスする

この論文をさがす

著者

抄録

症例は46歳,男性。34歳時に好酸球増加(WBC 38,200/μ<i>l</i>, 好酸球74%)と心嚢水貯留を認め,hypereosinophilic syndrome (HES)と診断された(染色体は正常核型)。化学療法にて軽快し以後無治療であったが,発症から12年後,発熱のため当院入院。WBC 3,000/μ<i>l</i>(芽球70%, 好酸球3%),骨髄は95%が芽球であった。芽球はmyeloperoxydase (MPO)染色陰性,CD13, CD19, CD34, HLA-DR, cytoplasmic MPOが陽性でありCD19陽性acute myeloblastic leukemiaと診断した。核型は46, XY, t(6;21)(q13;q22), add(7)(q11)で,AML1遺伝子の再構成は認めなかった。AdVP療法にて完全寛解となる。21q22と7qの異常を認めたことから,HESに対する化学療法が白血病の発症に関与した可能性も考えられた。

We report a rare case of hypereosinophilic syndrome (HES) that developed to acute myeloblastic leukemia (AML). The patient, a 34-year-old man, presented with eosinophilia of unknown origin (white blood cells 38,200/μ<i>l</i> with 74% eosinophils) and pericardial effusion, and was diagnosed as having HES with a normal karyotype. He received four cycles of combination chemotherapy including cyclophosphamide, cytosine arabinoside and vindesine, and thereafter remained in remission. After 12 years, he was referred to our hospital because of fever and malaise. On admission, CBC showed white blood cells 3,000/μ<i>l</i> with 70% myeloblasts and 3% eosinophils. The bone marrow was hypercellular with 95% blasts, which were negative for myeloperoxidase (MPO) staining. Immunophenotype analysis revealed that the cells were positive for CD13, CD19, CD34, HLA-DR and cytoplasmic MPO. CD19-positive AML was diagnosed. Cytogenetic analysis showed 46, XY, t(6;21)(q13;q22), add(7)(q11) in 19 of 20 metaphase spreads. Rearrangement of the AML1 gene at 21q22 and fusion of the <i>BCR/ABL</i> gene could not be detected by fluorescence in situ hybridization analysis. The patient received combination chemotherapy and achieved a complete remission. Chromosome aberrations involving 7q as well as 21q22 suggested that the initial chemotherapy for HES might have been implicated in the pathogenesis of acute leukemia in this case.

収録刊行物

  • 臨床血液

    臨床血液 41(9), 723-728, 2000-09-30

    一般社団法人 日本血液学会

参考文献:  10件中 1-10件 を表示

被引用文献:  1件中 1-1件 を表示

各種コード

  • NII論文ID(NAID)
    10008038210
  • NII書誌ID(NCID)
    AN00252940
  • 本文言語コード
    JPN
  • 資料種別
    NOT
  • ISSN
    04851439
  • NDL 記事登録ID
    6295471
  • NDL 雑誌分類
    ZS21(科学技術--医学--内科学)
  • NDL 請求記号
    Z19-295
  • データ提供元
    CJP書誌  CJP引用  NDL  J-STAGE 
ページトップへ