【摘要】 目的:探讨母细胞性浆细胞样树突细胞肿瘤(BPDCN)的临床表现、诊断、治疗方案及预后。方法:回顾性分析经骨髓穿刺及淋巴结活检确诊的4例BPDCN患者的临床特征、骨髓形态及免疫表型、治疗及预后。结果:4例患者中均有骨髓及脾脏、淋巴结累及，2例皮肤浸润，3例出现中枢神经系统浸润。骨髓中异常细胞形态可见拖尾状，免疫分型显示4例患者均表达CD56、CD4和CD123,3例患者表达CD304。1例患者拒绝化疗早期死亡；2例患者初始应用DA+VP方案治疗后均达完全缓解，其中1例在复发后应用该方案再次达完全缓解；1例患者应用减低剂量DA+VP化疗无效，之后应用维奈克拉+阿扎胞苷达完全缓解。4例患者无疾病生存期为2-7个月，总生存期为2-33个月。结论:BPDCN患者的恶性细胞多浸润骨髓、脾脏及淋巴结并具有特殊表型，且预后差。治疗方案应兼顾髓系及淋巴系，含新药的方案如BCL-2抑制剂联合去甲基化药物值得尝试。更多还原

【Abstract】 Objective: To explore the clinical manifestations, diagnosis, treatment and prognosis of blastic plasmacytoid dendritic cell neoplasm(BPDCN). Methods: The clinical features, bone marrow morphology and immunophenotyping, treatment and prognosis of 4 patients with BPDCN were analyzed retrospectively. Results: 4 patients had bone marrow, spleen and lymph nodes involvement, 2 patients had skin lesions, and 3 patients had central nervous system infiltration. Tailing phenomenon of abnormally cells could be seen in bone marrow. The immunophenotyping showed that CD56, CD4 and CD123 expression was observed in 4 patients, and CD304 in 3 patients. One patient refused chemotherapy and died early. Both patients achieved complete remission after the initial treatment with DA+VP regimen, 1 of them achieved complete remission after recurrence by using the same regimen again. One patient failed to respond to reduced dose of DA+VP chemotherapy, and then achieved complete remission with venetoclax+azacitidine. Conclusion: The malignant cells in BPDCN patients often infiltrate bone marrow, spleen and lymph nodes, and have specical phenotypes, with poor prognosis. The treatment should take into account both myeloid and lymphatic systems. The treatment containing new drugs such as BCL-2 inhibitors combined with demethylation drugs is worth trying.更多还原