Acute pancreatitis-onset of chronic myelogenous leukemia with transformation into extramedullary acute lymphoblastic leukemia: report of one case and review of literature
{"title":"Acute pancreatitis-onset of chronic myelogenous leukemia with transformation into extramedullary acute lymphoblastic leukemia: report of one case and review of literature","authors":"Xin Su, Chengshun Chen","doi":"10.3760/CMA.J.ISSN.1006-9801.2019.12.011","DOIUrl":null,"url":null,"abstract":"目的 \n探讨以不典型症状起病的慢性粒细胞白血病(CML)发生髓外急性淋巴细胞白血病(ALL)转变的临床影像学特征及诊疗方法。 \n \n \n方法 \n回顾性分析北京中医药大学东直门医院收治的1例以急性胰腺炎起病的CML髓外ALL转变患者临床资料,并复习相关文献。 \n \n \n结果 \n该患者确诊为CML慢性期,伊马替尼治疗10个月后,突发左侧中上腹疼痛,进食后加重,血清脂肪酶水平升高,多发皮下结节,影像学改变符合急性胰腺炎,予抗感染、对症治疗无效。3 d后经骨髓穿刺明确诊断为CML急性期,ALL转变,高度怀疑白血病细胞浸润胰腺,立即开始达沙替尼联合VDCD方案治疗,48 h后血清脂肪酶降至正常,腹痛、腹胀症状消失,皮下结节迅速缩小、消退,临床符合ALL胰腺、皮肤浸润。 \n \n \n结论 \nCML髓外ALL转变发生于胰腺较为少见,及时评价药物疗效,加强BCR-ABL融合基因及ABL激酶突变检测,对发现疾病进展有积极意义。","PeriodicalId":9505,"journal":{"name":"肿瘤研究与临床","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2019-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"肿瘤研究与临床","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3760/CMA.J.ISSN.1006-9801.2019.12.011","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"Medicine","Score":null,"Total":0}