興味ある経過を示した骨髄性白血病の一例

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書誌事項

タイトル別名
  • Acute Myeloblastic Exacerbation of Chronic Myelogenous Leukemia
  • キョウミ アル ケイカ オ シメシタ コツズイセイ ハッケツビョウ ノ イチレイ
  • A Case with Prolonged Survival Time Presumably due to Its Early Detection.

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抄録

Chronic myelogenous leukemia has been known to shift to acute myeloblastic leukemia in considerably high frequency, which, once developed, terminates within 3 months in average according to the literature.1)∼6)12)<br>Recently, we have had a case of a 53-year-old man with myelogenous leukemia, in which a neuralgic pain appeared in the thighs as an initial symptom approximately 10 months prior to the death, being associated with fever, hemorrhagic tendency of extensive degree, thrombocytopenia (8,580/cmm.) and a marked proliferation of myeloblasts (89.2%) in the bone marrow. At the same time, this patient has shown the symptoms and signs characteristic of chronic myelogenous leukemia such as hepatosplenomegaly, leukocytosis (17,600/cmm.) consisting mainly of neutrophils of intermediate maturity (myeloblast 5%, promyelocyte 0%, myelocyte 14%, metamyelocyte 0%, band 20% and PMN 18%), and moderate anemia (Hb 10.7gm/dl, RBC 429×104/cmm). From these findings we believed that this case was just at the early stage of its myeloblastic transformation.<br>After several incomplete remissions with prompt treatments such as blood transfusion, antibiotics, antihemorrhagic agents, adrenocorticosteroid hormones and 6-MP, this patient died with a rather long survival of 10 months.<br>Autopsy revealed a marked, diffuse proliferation of the leukemic cell in the bone marrow, associated with a proliferation of the argentaffine fibers. The liver weighed 2, 680gm, the spleen 820 gm. and the other organs were also occupied by the dominating leukemic cells.<br>Although there was still the possibility to be an aleukemic type of acute myelogenous leukemia, characterized by absence of myeloblasts in the peripheral blood, this case could more reasonably be regarded as an acute exacerbation of chronic myelogenous leukemia from both the clinical and pathological points of view. And if it be true, it should be emphasized that the acute myeloblastic leukemia transformed from chronic type, could be detected at an early stage and prolonged its survival time, being treated appropriately as soon as possible.

収録刊行物

  • 臨床血液

    臨床血液 7 (3), 313-320, 1966

    一般社団法人 日本血液学会

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