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1970年Allan提出治疗相关性白血病(Therapy-related Leukemia,TRL)的概念,它是指某种疾病经化疗和/或放疗后继发的白血病。本文报告2例用乙亚胺类药物治疗银屑病后发生的白血病、连同截止1987年底国内期刊报道的30例的临床资料进行综合分析,旨在摸索规律、引起注意。病例报告例1 男、25岁。因鼻衄、乏力10天于1987年10月14日入院。患者银屑病史9年。1984年2月至1987年6月间断服乙亚胺,总量250克。无其它毒物接触史及肿瘤家族史。查:T36.8℃。皮肤散在紫癜。淋巴结、肝、脾不大。胸骨压痛。Hb42g/L,WBC3.8×10~9/L、幼稚细胞66%,BPC14×10~9/L。纤维蛋白原0.6～1.2g/L。骨髓增生极度活跃,早幼粒61%、过氧化酶强阳性。诊断:早幼粒细胞白血病(M3),疑弥漫性血管内凝血(DIC)。对症治疗无效于入院后第5天死于脑出血。例2 女、48岁。因乏力2个月、发烧伴出血
In 1970, Allan proposed the concept of Therapy-related Leukemia (TRL), which refers to the leukemia secondary to chemotherapy and / or radiotherapy of a disease. This article reports 2 cases of acetaminophen for the treatment of leukemia after psoriasis, as of the end of 1987 as reported by the domestic journals of 30 cases of clinical data for a comprehensive analysis aimed at exploring the law to attract attention. Case report 1 male, 25 years old. Due to epistaxis, fatigue 10 days in 1987 October 14 admission. Patients with psoriasis for 9 years. February 1984 to June 1987 intermittent ethylene imine, a total of 250 grams. No other toxic contact history and family history of cancer. Check: T36.8 ℃. Skin purpura. Lymph nodes, liver, spleen is not large. Sternal tenderness. Hb42g / L, WBC3.8 × 10 ~ 9 / L, 66% of naive cells, BPC14 × 10 ~ 9 / L. Fibrinogen 0.6 ~ 1.2g / L. Myeloid hyperplasia is extremely active, promyelocytic 61%, strong positive peroxidase. Diagnosis: promyelocytic leukemia (M3), suspected diffuse intravascular coagulation (DIC). Symptomatic treatment ineffective died of cerebral hemorrhage on day 5 after admission. Example 2 Female, 48 years old. 2 months because of fatigue, fever with bleeding