内容紹介
Effectiveness of Azacitidine in Chronic Myelomonocytic Leukemia Harboring del(20q)―A Case Report
Summary
A 71-year-old man was admitted to our hospital with leukocytosis and anemia. Chronic myelomonocytic leukemia(CMML)harboring del(20q)was diagnosed by peripheral blood examination and bone marrow aspiration. The patient was subsequently treated with azacitidine, which resulted in rapid disappearance of monocytosis and resolved his dependency on red cell transfusion. With regard to the chromosomal abnormality, although del(20q)is estimated to be encountered in approximately 0.7-1.0% of all CMML cases, its significance in prognosis has not been fully analyzed. Hence, more such cases need to be evaluated to elucidate the therapeutic outcome of CMML involving del(20q). In addition, the Wilms tumor-1(WT 1)level in the patient gradually decreased after the initiation of azacitidine therapy. This phenomenon of WT1 decrease synchronizing with the patient's clinical improvement might reflect therapeutic efficacy with regard to the clinical course, as had been observed in acute myeloid leukemia and myelodysplastic syndrome.
要旨
症例は71歳,男性。白血球増加・貧血のため当科紹介入院となり,末梢血液像・骨髄検査の結果,del(20q)を含む染色体異常を有する慢性骨髄単球性白血病(chronic myelomonocytic leukemia: CMML)と診断した。azacitidineでの治療を開始して以降,効果は速やかに得られ,単球数正常化・輸血依存性の離脱が可能であった。CMMLにおけるdel(20q)は0.7～1.0%にみられるまれな異常であるが,予後に対する影響など今後の症例蓄積による多数例での解析が望まれる。また,本例では治療開始以降症状が改善するとともにWT1低下がみられたが,急性骨髄性白血病や骨髄異形成症候群で報告されているのと同様に,効果を反映して低下したものと考えられた。
目次
Summary
A 71-year-old man was admitted to our hospital with leukocytosis and anemia. Chronic myelomonocytic leukemia(CMML)harboring del(20q)was diagnosed by peripheral blood examination and bone marrow aspiration. The patient was subsequently treated with azacitidine, which resulted in rapid disappearance of monocytosis and resolved his dependency on red cell transfusion. With regard to the chromosomal abnormality, although del(20q)is estimated to be encountered in approximately 0.7-1.0% of all CMML cases, its significance in prognosis has not been fully analyzed. Hence, more such cases need to be evaluated to elucidate the therapeutic outcome of CMML involving del(20q). In addition, the Wilms tumor-1(WT 1)level in the patient gradually decreased after the initiation of azacitidine therapy. This phenomenon of WT1 decrease synchronizing with the patient's clinical improvement might reflect therapeutic efficacy with regard to the clinical course, as had been observed in acute myeloid leukemia and myelodysplastic syndrome.
要旨
症例は71歳,男性。白血球増加・貧血のため当科紹介入院となり,末梢血液像・骨髄検査の結果,del(20q)を含む染色体異常を有する慢性骨髄単球性白血病(chronic myelomonocytic leukemia: CMML)と診断した。azacitidineでの治療を開始して以降,効果は速やかに得られ,単球数正常化・輸血依存性の離脱が可能であった。CMMLにおけるdel(20q)は0.7～1.0%にみられるまれな異常であるが,予後に対する影響など今後の症例蓄積による多数例での解析が望まれる。また,本例では治療開始以降症状が改善するとともにWT1低下がみられたが,急性骨髄性白血病や骨髄異形成症候群で報告されているのと同様に,効果を反映して低下したものと考えられた。