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例1 男,29例。因头昏、乏力、牙龈出血20余天,于1987年4月21日入院。查体:T 38℃,轻度贫血貌,浅表淋巴结不肿大,皮肤无瘀点瘀斑,有胸骨压痛,心肺正常,肝脾未触及。血象:Hb90g/L,BPC 40×10~9/L,WBC 4.5×10~9/L,原粒0.01,早幼粒0.85,杆状核0.02,分叶核0.03,淋巴0.09。骨髓象:增生明显活跃,早幼粒细胞占0.88,胞浆内有粗大灰蓝色颗粒,可见Auer小体,红、巨核系列受抑制,血小板散在少见。过氧化酶染色阳性,非特异性酯酶染色阳性。诊断:急性早幼粒细胞白血病(M3a)。入院后经抗感染,输血等一般支持疗法,并给予HA方案(三尖杉酯碱4mg/d,阿糖胞苷100mg/d)4个疗程达完全缓解。出院后随访3年持续缓解。
Example 1 Male, 29 cases. He was admitted to hospital on April 21, 1987 for dizziness, fatigue, and gum bleeding for more than 20 days. Physical examination: T 38°C, mild anemia appearance, superficial lymph nodes are not swollen, skin has no blemishes, and sternal tenderness, normal heart and lung, liver and spleen are not touched. Blood: Hb90g/L, BPC 40×10~9/L, WBC 4.5×10~9/L, original grain 0.01, early grain 0.85, rod-shaped nucleus 0.02, lobar nucleus 0.03, lymphatic 0.09. Bone marrow like: hyperplasia was apparently active. Promyelocytic cells accounted for 0.88. There were coarse gray-blue particles in the cytoplasm. The Auer bodies were seen, red and giant nucleus series were inhibited, and platelets scattered in rare cases. Peroxidase staining was positive and non-specific esterase staining was positive. Diagnosis: Acute promyelocytic leukemia (M3a). After admission, he received general supportive therapy such as anti-infection and blood transfusion, and he received HA program (harringtonine 4 mg/d, cytarabine 100 mg/d) for 4 courses of complete remission. A follow-up of 3 years after discharge was continued.