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本文报道一例急粒患者,经同种异体骨髓移植临床缓解5(1/2)年后,发生了少见的髓外复发。患者13岁,男性,于1968年1月诊断为急性粒细胞性白血病。骨髓穿刺显示原粒细胞70%,并含有许多奥尔氏小体。用阿糖胞苷治疗获得临床缓解,但于1969年4月出现了骨髓复发。尽管应用了红比霉素、长春新碱、强的松、氨甲蝶呤、6-巯基嘌呤和左旋门冬酰胺酶等各种联合化疗方案,2(2/2)年中先后出现了4次缓解和复发。于1971年9月再次复发时,决定进行同种异体骨髓移植。供者为人体的细胞抗原(HLA)相同与混合白细胞培养(MLC)相容的同胞兄弟。患者先用环氯乙酰亚硝脲、阿糖胞苷、6-硫代鸟嘌呤和环磷酰胺作4天以上移植前准备;24小时后给予静脉输注约2.5×10~(10)的供者
This article reports a case of acute granulomatous patients, after allogeneic bone marrow transplantation clinical remission 5 (1/2) years after the occurrence of a rare extramedullary recurrence. The patient, 13 years old, male, diagnosed as acute myeloid leukemia in January 1968. Bone marrow aspirates showed 70% of myeloblasts and contained many Auricles. Clinical remission was achieved with cytarabine treatment, but bone marrow recurrence occurred in April 1969. Despite various combination chemotherapies such as diclofenac, vincristine, prednisone, methotrexate, 6-mercaptopurine and levo-asparaginase, 4 (2/2) years have seen 4 Times relief and relapse. In September 1971 again relapse, it was decided to carry out allogeneic bone marrow transplantation. The donor is a human sibling that has the same HLA as the compatible white blood cell culture (MLC). Patients with cyclothronitrile nitrosourea, cytarabine, 6-thioguanine and cyclophosphamide for more than 4 days before transplantation; intravenous infusion of about 2.5 × 10 ~ (10) for 24 hours after the provision of By