急性粒-单核细胞白血病合并指状突树突细胞肉瘤一例并文献复习

摘要

目的 进一步认识指状突树突细胞肉瘤(IDCS)的生物学属性和临床特征.方法 以迄今所报道的第一例IDCS合并急性粒-单核细胞白血病患者为研究对象,结合文献复习总结该病的生物学及临床特征.结果 该例患者有前驱肿瘤病史及放化疗史,考虑为治疗相关性树突细胞肉瘤,根据实验室检测结果考虑两种肿瘤同为髓系来源.患者对连续4次化疗反应不佳.数据库检索到的62例IDCS患者中,17％曾有恶性肿瘤及放化疗治疗史,此类患者预后更为恶劣.结论 IDCS预后差,其中治疗相关性类型预后更差.加强对接受化疗和(或)放疗的肿瘤或非肿瘤患者的癌症预防和早期检测有重要的临床意义.%Objective To summarize and learn the biological properties and clinical features of interdigitating dendritic cell sarcomas (IDCS).Methods The first IDCS patient concurrent with acute myelomonocytic leukemia (AML-M4) described herein,to our knowledge,was studied and 62 IDCS cases reported previously in the literature were reviewed.Results The patient had a history of breast cancer as well as radiotherapy and chemotherapy of it,and the patient showed poor response to 4 cycles of sequential chemocherapy regimens.Based on the laboratory results,IDCS and AML-M4 in this patient were both of myelogenous origination.Furthermore,review of the 62 IDCS patients reported previously showed that as high as 17 ％ of the patients had malignant disease and received radiotherapy or chemotherapy before they got IDCS,and patients of this group had worse prognosis compared with counterpart.Conclusion IDCS has poor prognosis,and therapy-related type worse.Prophylactic measures and stringent screening of the second cancer in those who received chemoterapy or radiotherapy are appropriated and necessary.