异基因造血干细胞移植治疗耳道复发的急性早幼粒细胞白血病一例并文献复习

目的:探讨急性早幼粒细胞白血病(APL)髓外复发的相关因素及治疗。方法:对1例APL缓解后耳道复发患者的临床资料进行回顾性分析,并复习相关文献。结果:患者2015年8月诊断为APL(低危型),经诱导后达完全缓解,随后进行巩固、维持治疗,并多次行腰椎穿刺术及椎管内注射化疗药物预防中枢神经系统白血病。2017年3月发现左外耳道新生物,活检确诊外耳道髓系肉瘤,示髓外复发。随后出现骨髓复发。经诱导巩固化疗后行异基因造血干细胞移植,存活至今。结论:对于髓外复发的急性早幼粒细胞白血病,其预后较差,异基因造血干细胞移植治疗有较好疗效。

Allogenei Hematopoietic Stem Cell Transplantation for Acute Promyelocytic Leukemia with Ear Canal Recurrence: A Case Report and Review of the Literature

ABSTRACT Objective: To investigate the related factors and treatment of extramedullary relapse of acute promyelocytic leukemia (APL). Methods: One case with recurrence of myeloid sarcoma in the auditory meatus after remission of APL was retrospectively inspected, and related documents were carefully reviewed. Results: The patient was diagnosed of APL (low risk group) in August, 2015. She was totally relived after induction therapy and then persistently accepted maintenance therapy. Multiple times of lumbar puncture and Intraspinal injection of chemotherapy drugs were conducted to prevent central nervous system leukemia, and then she was detected of neoplasm in the auditory meatus and biopsy showed myeloid sarcoma in March, 2017. Then he had relapse acute leukemia in the bone marrow. After induction chemotherapy and allogeneic hematopoietic stem cell transplantation he was alive till now. Conclusion: The patients with extramedullary recurrence of APL has poor prognosis and allogeneic hematopoietic stem cell transplantation is an effective treatment for those patients.