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中华肝脏外科手术学电子杂志

中华肝脏外科手术学电子杂志 ›› 2012, Vol. 01 ›› Issue (02) : 109 -112. doi: 10.3877/cma.j.issn.2095-3232.2012.02.009

所属专题： 文献；

临床研究

肝胰十二指肠器官簇移植术后急性单核细胞白血病诊治特点
郑永江1, 李旭东1, 赖文兴1, 林东军1,†()   
  1. 1. 510630　广州，中山大学附属第三医院血液科　中山大学血液病研究所
  • 收稿日期:2012-08-04 出版日期:2012-10-10
  • 通信作者: 林东军

Treatment of acute monocytic leukemia after combined en-bloc liver and pancreas transplantation

Yong-jiang ZHENG1, Xu-dong LI1, Wen-xing LAI1, Dong-jun LIN1,†()   

  1. 1. Department of Hemotology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China
  • Received:2012-08-04 Published:2012-10-10
  • Corresponding author: Dong-jun LIN
  • About author:
    Corresponding author: LIN Dong-jun, Email:
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郑永江, 李旭东, 赖文兴, 林东军. 肝胰十二指肠器官簇移植术后急性单核细胞白血病诊治特点[J]. 中华肝脏外科手术学电子杂志, 2012, 01(02): 109-112.

Yong-jiang ZHENG, Xu-dong LI, Wen-xing LAI, Dong-jun LIN. Treatment of acute monocytic leukemia after combined en-bloc liver and pancreas transplantation[J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2012, 01(02): 109-112.

目的

探讨肝胰十二指肠器官簇移植术后急性单核细胞白血病的诊治特点。

方法

回顾性分析2011年10月在中山大学附属第三医院血液科诊治的1例肝胰十二指肠器官簇移植术后急性单核细胞白血病患者的临床资料。患者男性，62岁，已签署知情同意书，符合医学伦理学规定。总结分析患者的临床表现，血常规检查、骨髓形态学检查、染色体核型分析及融合基因检测结果，诊治经过，并复习相关文献。

结果

该例肝胰十二指肠器官簇移植术后白血病患者缺乏特异性临床表现，术后22 d血常规检查发现全血细胞减少，其后多次出现全身出血点和肺部感染。经骨髓形态学检查、染色体核型分析及融合基因检测等确诊为急性单核细胞白血病。给予大剂量化学药物治疗（化疗）仍未缓解，治疗过程中多次出现感染，最终因并发感染死亡。

结论

肝胰十二指肠器官簇移植术后急性单核细胞白血病临床少见，缺乏特异性临床表现，确诊主要依靠实验室检查，化疗效果较差，病死率高。

关键词: 肝移植, 白血病，单核细胞，急性, 诊断, 化学药物治疗
Objective

To investigate the clinical characteristics, diagnosis and treatment of acute monocytic leukemia after combined en-bloc liver and pancreas transplantation.

Methods

Clinical data of one patient(male, 62 years), diagnosed as acute monocytic leukemia after combined en-bloc liver and pancreas transplantation in Department of Hematology of the Third Affiliated Hospital of Sun Yat-sen University on October 2011 was analyzed retrospectively. Local ethical committee approval had been received and that the informed consent of the participating subject was obtained. Blood routine, bone marrow morphological examination, karyotype and fusion gene detection result were analyzed.

Results

The patient had no specific clinical manifestation except for recurrent hemorrhagic spot and lung infection after combined en-bloc liver and pancreas transplantation. Pancytopenia was found by blood routine examination 3 months after operation. The diagnosis of acute monocytic leukemia was confirmed by bone marrow morphological examination, karyotype analysis and fusion gene detection. High-dose chemotherapy was given to the patient, but no complete remission was achieved. The patient died of severe infection.

Conclusions

Acute monocytic leukemia is a rare complication after combined en-bloc liver and pancreas transplantation. There is no specific clinical manifestation. Laboratory examination is the main method of diagnosis. The efficacy of chemotherapy is poor and the mortality is high.

Key words: Liver transplantation, Leukemia, monocytic, acute, Diagnosis, Chemotherapy
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