再生障碍性贫血白血病病变4例临床分析

摘要

Objective To explore the possible mechanism in patients with aplastic anemia who evolved into leukemia. Method Clinical features and treatment were retrospectively analysed in four cases of aplastic anemia who evolved into leukemia. Results 4 cases of AA pa-tients received androgen therapy;One case of patients received CsA combined with ATG and G-CSF and EPO at the same time;One case of patients received CsA combined with G-CSF. Despite receiving chemotherapy,the prognosis was poor in all of 4 cases of AA patients who evolved to leukemia,their survival were no more than six months. Conclusion AA patient may have a defective HSC / HPC or stored abnormal hematopoietic clone,This may cause AA patient evolved into leukmiea. Once converted to leukemia,the patients are poor progno-sis,chemotherapy is mostly ineffective.%目的：分析再生障碍性贫血患者发生白血病病变的可能机制。方法：回顾性分析4例再障发生白血病病变患者的临床特征及治疗方案。结果：4例AA患者均接受雄激素治疗；1例患者同时接受环孢素、抗胸腺淋巴细胞球蛋白（ ATG）、重组人粒细胞刺激因子、重组人促红细胞生成素治疗；1例患者同时接受环孢素、重组人粒细胞刺激因子治疗。4例患者白血病病变后化疗效果差，生存期均未超过6个月。结论：AA患者体内存在有缺陷的HSC/HPC或预存的异常造血克隆，可能是其转变为白血病的根本原因。一旦转为白血病后，化疗多为无效，患者预后极差。