[白血病前期]。

Bilten za hematologiju i transfuziju Pub Date : 1983-01-01
D Janić, E Stojimirović
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摘要

处理白血病前期综合征的病例报告很少。在过去的几年里,白血病前期的定义一直不明确。目前,大多数作者都认为,骨髓干细胞疾病与临床可识别的血液学异常,其发展为显性白血病,被认为是白血病前期综合征。以急性淋巴细胞白血病(ALL)和急性非淋巴细胞白血病(ANLL)结束的白血病前期综合征的临床和血液学特征是不同的。我们描述了两个白血病前期病例——第一个演变为ALL,第二个演变为ANLL。我们的第一位患者在急性淋巴细胞白血病前5个月出现了全血细胞减少症和骨髓细胞减少症。在确诊的那一刻,临床检查显示淋巴腺、肝脏和脾脏肿大。实验室检查显示全血细胞减少和骨髓浸润母细胞L1形态(f.a.b.分类)。以ANLL结束的白血病前期以全血细胞减少和组织细胞浸润的高细胞骨髓为特征,一些表现为红细胞、白细胞和血小板摄取征象。急性单核细胞白血病M5 (f.a.b.)在发病3个月后根据骨髓单核细胞浸润诊断。临床和血液学特征有助于识别白血病前期综合征进行了讨论。
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[Preleukemia].

Case reports dealing with preleukemic syndromes are rare. During the last years preleukemia has been ill defined. Nowadays, most authors agree that a marrow stem disorder with clinically recognisable haematological abnormalities, which proceed the development of overt leukemia, is to be regarded as preleukemia syndrome. Clinical and haematological features are different in preleukemic syndromes terminating with acute lymphoblastic (ALL) and acute non-lymphoblastic leukemia (ANLL). We describe two cases of preleukemia--the first evolving into ALL and the second into ANLL. Our first patient had developed pancytopenia and hypocellular bone marrow five months before overt ALL. In the moment the diagnosis was made clinical examination revealed enlarged lymph glands, liver and spleen. Laboratory tests showed pancytopenia and bone marrow infiltrated with blasts L1 morphology (F. A. B. classification). Preleukemic phase terminating with ANLL featured pancytopenia and hypercellular bone marrow infiltrated with histiocytes, some showing signs of erythrocyte-, leukocyte- and platelet-ingestion. Diagnosis of acute monoblastic leukemia M5 (F. A. B.) was made three months after the illness onset, according to bone marrow infiltration with monoblasts. Clinical and haematological features helpful in the recognition of preleukemic syndromes are discussed.

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