悪性リンパ腫治療後に発症した慢性骨髄性白血病に対するinterferon-α hydroxycarbamide併用著効例  [in Japanese] Successful Treatment of Combined Interferon-α and Hydroxycarbamide for Chronic Myelogenous Leukemia Following Therapy for Malignant Lymphoma  [in Japanese]

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Abstract

症例は57歳,女性。1988年2月,非Hodgkinリンパ腫(follicular mixed cell, B-cell type, StageIII)と診断され,アルキル化剤,エトポシドを含む化学療法および放射線療法を6年間にわたり施行された。リンパ節腫大は不完全寛解の状態であったが,1994年4月,末梢血にて好塩基球増多を伴う白血球増多及び血小板増多を認めた。骨髄細胞の染色体分析ではPh染色体を認め,さらにbcr遺伝子の再構成を認めた。悪性リンパ腫の治療歴と経過から二次性慢性骨髄性白血病と診断した。なお初診時のリンパ節細胞の染色体分析では正常核型であり,1993年に採取したリンパ節細胞にはbcr遺伝子の再構成はみられなかった。同年7月よりinterferon-α (IFN-α)およびhydroxycarbamideを投与したところ,Ph染色体の消失および腫大したリンパ節の縮小を認めた。本症例はIFN-αおよびhydroxycarbamideが二次性慢性骨髄性白血病に対しても有効であることを示唆している。

A 57-year-old waman was diagnosed as having non-Hodgkin lymphoma (follicular mixed cell, B-cell type, Stage III) in February 1988. Since then, she had been treated with radiation and chemotherapy contained with alkylating agents and etoposide for 6 years. In April 1994, peripheral blood study disclosed leukocytosis with basophilia and thrombocytosis. Bone marrow was hypercellular. The karyotype of bone marrow cells was 46, XX, t(9;22)(q34;q11). Rearrengement of bcr was detected in bone marrow, but not in lymph node cells. On the basis of these findings, she was diagnosed as having the chronic phase of chronic myelogenous leukemia (CML) following the therapy for malignant lymphoma and treated with interferon-α (IFN-α) and hydroxycarbamide. Following this therapy, the lymphoadenopathy promptly disappeared and chromosome analysis showed disappearance of Ph chromosome positive cells. Although CML is rare in secondary leukemia, the present case seemed therapy-related CML and the treatment with IFN-α and hydroxycarbamide was effective for both CML and malignant lymphoma.

Journal

  • Rinsho Ketsueki

    Rinsho Ketsueki 37(9), 853-857, 1996-09-30

    The Japanese Society of Hematology

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