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Eşzamanlı Nadir Görülen Bir Birliktelik: Tüylü Hücreli Lösemi ve Kronik Miyeloid Lösemi

Unusual Synchronous Diagnoses: Hairy Cell Leukemia and Chronic Myeloid Leukemia

Journal Name:

  • Fırat Tıp Dergisi

Publication Year:

  • 2012

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Abstract (2. Language): 
Hairy cell leukemia (HCL) and chronic myeloid leukemia (CML) are two different hematological diseases. The occurence of a secondary malignancy belong the course of HCL is not unusual. But the most frequent secondary malignancies of HCL are the solid tumors and the other lymphoproliphera-tive diseases. We diagnosed a patient with pancytopenia as HCL by bone marrow aspiration and biopsy, flowcytometry of bone marrow and tartrate-resistant acid phosphatase (TRAP) test done in bone marrow. The cytogenetic analysis made by real time (RT)-PCR showed that BCR-ABL t (9;22) was positive. Quantitative measurement of BCR-ABL fusion transcripts was 0.27. As a result it was thought that there are two synchronous malignancies seen in the same patient. The patient was treated with 2 chlorodeoxyadenosine (2-CdA). Imatinib mesylate orally at a dose of 400 mg daily was planned to be continued after the remission of HCL. The synchronicity of HCL and CML can be found in the literature as case reports. This case is presented as a rare condition for overwiewing the treatment and the follow up.
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Abstract (Original Language): 
Tüylü hücreli lösemi (THL) ve kronik miyeloid lösemi (KML) iki farklı hematolojik hastalıktır. THL seyrinde ikinci bir malignitenin birlikte görülmesi nadir değildir. Ancak THL seyrinde en sık görülen ikinci maligniteler solid tümörler veya diğer lenfoproliferatif hastalıklardır. THL ile birlikte eş zamanlı KML' nin görülmesi oldukça nadir görülen bir durumdur. Pansitopeni tablosu ile başvuran olgumuzda yapılan çevre kanı incelemesi, kemik iliği aspirasyon ve biyopsinin değerlendirilmesi, kemik iliğinden akım sitometri incelemesi ve kemik iliği biyopsi preparatında yapılan tartarata rezistan asit fosfataz (TRAP) boyası sonrasında THL tanısı konuldu. Yapılan sitogenetik değerlendirme sonucu real time (RT)-PCR yöntemi ile bakılan BCR-ABL t (9;22) pozitif olarak bulundu. Kantitatif BCR-ABL füzyon transkriptinin oranı ise 0.27 olarak saptandı. Böylece olguda 2 farklı malignitenin bir arada eş zamanlı olarak ortaya çıktığı düşünüldü. Hastaya 2-klorodeoksiadenozin (2-CdA) başlandı. THL remisyona girdikten sonra KML için imatinib mesilat 400 mg/gün ile tedaviye devam edilmesi planlanmaktadır. THL ile birlikte eş zamanlı olarak KML'nin görülmesi literatür¬de nadir vaka sunumları şeklinde bulunmaktadır. Bu olgu nadir görülmesi ve takip-tedavi stratejilerinin gözden geçirilmesi için sunuldu.
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  • 1
47-49
  • Turkish

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