DICを伴なう慢性骨髄性白血病の急性転化

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書誌事項

タイトル別名
  • Blastic Crisis of a Chronic Myelogenous Leukemia with Disseminated Intravascular Coagulation, with Special Reference to “AAAP” Therapy
  • DICを伴なう慢性骨髄性白血病の急性転化--AAAP療法に関連して
  • DIC オ トモナウ マンセイ コツズイセイ ハッケツビョウ ノ キュウセイ
  • —AAAP療法に関連して—

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説明

A 26 years old male with cholelithiasis was referred to our clinic because of marked leukocytosis. The hematological findings of peripheral blood and bone marrow and other signs such as a low score of neutrophil alkaline phosphatase and positive Philadelphia chromosome confirmed the diagnosis of chronic myelogenous leukemia (CML). A complete remission for 5 months was induced by busulfan therapy. After that, however, leukocytosis over than 50,000/cmm reappeared inspite of augmented dose of busulfan. The sternal aspirate of bone marrow showed a hypercellularity with granulocytic hyperplasia. There were 9 per cent myeloblasts, 3.5 per cent promyelocytes, 27.5 per cent myelocytes and 17.5 percent metamyelocytes, etc. Coagulation studies revealed slight decrease of fibrinogen in the plasma and positive FDP in the serum and thrombocytosis of 1,836,000/cmm. Under the diagnosis of early stage of blastic crisis of CML with subclinical disseminated intravascular coagulation (DIC), AAAP-therapy (Jap. J. Clin. Hemat., 19: 1332∼1340, 1978) was started immediately. On the 2nd day, coagulation studies showed further decrease of fibrinogen in the plasma, prolongation of prothrombin time and Kaolin partial thromboplastin time together with increased FDP in the serum, which suggested a deteriolation of DIC state. The combined treatment with heparin succeeded to subside the DIC and to introduce a complete remission, which was achieved after only one course of AAAP and maintained for two months and half.<br>It was suggested from the experience of this case that subclinical DIC may present inspite of thrombocytosis in CML, and the deteriolation of DIC should be estimated at vigorous chemotherapy for blastic crisis of CML.

収録刊行物

  • 臨床血液

    臨床血液 21 (1), 52-58, 1980

    一般社団法人 日本血液学会

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