摘要 目的：探讨异基因骨髓移植(allo-BMT)治疗慢性粒细胞性白血病(CML)骨髓纤维化的效果。方法：以allo-BMT治疗1例CML合并骨髓纤维化患者，并进行临床观察。结果：骨髓纤维化程度明显改善，骨髓有核细胞增生活跃；但白细胞升至正常约需90 d。结论：allo-BMT治疗CML骨髓纤维化有肯定疗效。
Reversal of severe bone marrow fibrosis following allogeneic
bone marrow transplantation for chronic granulocytic
leukemia (one case report)
XUE Mei JI Shu-quan CHEN Hui-ren WANG Heng-xiang ZHU Ling
(Department of Hematology, General Hospital of Air Force, Beijing 100036)
Abstract Objective:To study the reversal of severe bone marrow fibrosis following allogeneic bone marrow transplantation (allo-BMT) for chronic granulocytic leukemia.Method:The blood picture, bone marrow aspirates, marrow biopsy and reticulin fibrosis examination were performed before and after allo-BMT.Result:The severe bone marrow fibrosis was found in this patient before allo-BMT by marrow biopsy. The reticulin fibrosis grade was about “”in the corresponding specimen. The patients neutrophil count reached 1.0×109/L, platelet count reached 15×109/L on day +24, and cytogenetic manifestation showed it was donors on day+26 after allo-BMT. The severe marrow fibrosis was an abviously reversible on day +52 showed by marrow biopsy and reticulin fibrosis examination but the hematologic recovery was slow.Conclusion:The severe bone marrow fibrosis can be reversed by allo-BMT in patient with chronic granulocytic leukemia.
Key words Chronic myelocytic Leukemia Myelofibrosis Allogeneic bone marrow transplantation
异基因骨髓移植（allo-BMT）是根治慢性粒细胞性白血病（CML）的有效途径，但对CML骨髓纤维化的影响，文献报告很少。本文1例CML加速期合并明显骨髓纤维化患者，经allo-BMT后，骨髓纤维化程度明显改善。现报告如下。
1 资料与方法
患者，男，32岁。因左上腹胀满伴头昏、乏力3个月，于1998年9月入院。曾在当地医院诊断为CML，服用羟基脲治疗。体检：体温36.8℃，脉搏81次/min，心率15次/min，血压120/75 mmHg(1 mmHg=0.133 kPa)。贫血貌，全身皮肤粘膜无黄染、出血点，浅表淋巴结不肿大。胸骨中下段压痛，心肺听诊正常。肝脏未及，脾明显肿大，AB线11 cm ，AC线14 cm， MN线3 cm，质硬，轻触压痛。血象：Hb 61 g/L，WBC 15.8×109/L，分类：杆状0.09, 分叶0.21，嗜酸0.01，嗜碱0.10；中晚幼粒细胞0.39，淋巴0.08，有核红细胞0.06。BPC 474×109/L，Ret 0.032。骨髓检查第1次为干抽，第2次抽吸骨髓液外
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