【摘要】 目的探讨非白血病性粒细胞肉瘤的临床特点和治疗方法。方法回顾性分析12例非白血病性粒细胞肉瘤患者的临床资料,其中手术或放疗联合化疗5例,单纯化疗4例,自体干细胞移植1例,放疗加手术1例,单纯手术1例。化疗的患者均采用类似治疗非霍奇金淋巴瘤的方案(CHOP或DICE方案)。5例曾误诊为非霍奇金淋巴瘤,免疫组化检查后明确诊断。结果随访期间5例患者在治疗后由非白血病性粒细胞肉瘤转化为急性髓系白血病(AML),其中未接受化疗者2例,即只接受了局部手术或放疗者均转化为AML,由非白血病性粒细胞肉瘤转化为急性髓系白血病的中位间隔时间为6个月(3～10个月)。12例患者中位生存时间为11个月(4～35个月)。结论非白血病性粒细胞肉瘤误诊率高,免疫组化对于明确诊断十分重要;宜采用强有力的抗白血病样的化疗方案进行治疗以提高其生存率。更多还原

【Abstract】 Objective To analyze the clinical feature of nonleukemic granulocytic sarcoma (GS) and treatment effects. Methods From February 1985 to January 2008,12 nonleukemic GS patients were evaluated retrospectively. Five of them were treated with systemic chemotherapy combined with surgical resection or local irradiation,four with systemic chemotherapy alone,one with bone marrow transplantation,one with surgical resection plus local irradiation and one with resection alone. The regimens of chemotherapy were CHOP or DICE. Five patients (41.7%) were initially misdiagnosed as non -Hodgkin’s lymphoma. Results During the period of follow -up,five patients (41.7% ) progressed to acute myeloid leukemia (AML),two of them had not received systemic chemotherapy. The median of interval period between GS and AML was six months (ranging from 3 to 10 months). The median survival time of all patients was 11 months (ranging from 4 to 35 months). Conclusions Nonleukemic granulocytic sarcomas are usually misdiagnosed as non-Hodgkin’s lymphoma. Immunohistochemistry is essential for the diagnosis of GS. Intensive chemotherapy similar with that used to treat leukemia would increase the survival rate for these patients.更多还原