急性髓性白血病合并多发性骨髓瘤:依托泊苷、硫鸟嘌呤和阿糖胞苷成功治疗一例

Alev Akyol Erikci, Ahmet Ozturk, Emre Tekgunduz, Ozkan Sayan
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引用次数: 7

摘要

背景:急性白血病和多发性骨髓瘤(MM)的关联通常不仅被描述为化疗的并发症,而且在没有化疗的情况下或在诊断时同时发生。这种白血病典型的是急性髓性白血病(AML)。骨髓单核细胞亚型尤其常见。病例报告我们报告一例68岁女性在诊断为轻链(κ)骨髓瘤2年后发展为AML。患者口服美法兰和强的松治疗MM。由于心脏表现不佳,患者给予蒽环类药物缺乏治疗,包括依托泊苷120 mg/m2,硫鸟嘌呤100 mg/m2口服2次,每日1-5天,阿糖胞苷40 mg/m2皮下注射(ETC)。结论经ETC治疗后,患者血液学完全缓解29个月。这种疗法可能是继发性白血病的安全选择,特别是对老年患者。
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Acute Myeloid Leukemia Complicating Multiple Myeloma: A Case Successfully Treated With Etoposide, Thioguanine, and Cytarabine

Background

The association of acute leukemia and multiple myeloma (MM) has been usually described not only as a complication of chemotherapy but also in the absence of chemotherapy or together at the time of diagnosis. Such leukemias are typically acute myeloid leukemia (AML). The myelomonocytic subtype is particularly found.

Case Report

We report a case of a 68-year-old female who developed AML 2 years after the diagnosis of light chain (κ) myeloma. She had been treated with oral melphalan and prednisone for MM. The patient was treated with an anthracycline-lacking therapy consisting of etoposide 120 mg/m2, thioguanine 100 mg/m2 orally twice daily on 1-5 days, and cytarabine 40 mg/m2 subcutaneously on day 1 (ETC) because of poor cardiac performance.

Conclusion

Following ETC therapy our particular patient has been in complete hematologic remission for 29 months. This therapy might be a safe alternative in secondary leukemia especially for elderly patients.

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