Acute leukemia in rheumatoid arthritis treated with cytotoxic agents.
Acute leukemia in rheumatoid arthritis treated with cytotoxic agents.
复制标题
用细胞毒药物治疗类风湿性关节炎中的急性白血病。
作者：
Seidenfeld Am;Smythe Ha;M. A. Ogryzlo;M. Urowitz;Dotten Da
急性白血病是描述在两个病人用细胞毒性药物治疗的破坏性，血清阳性类风湿关节炎。两例患者均接受长期硫唑嘌呤治疗。此外，1例患者接受环磷酰胺治疗，另1例接受美法仑治疗。两例患者均观察到染色体异常。对一名患者的研究包括集落形成单位、铁动力学、骨髓电子显微镜检查和尸检。本文综述了迄今为止文献中与细胞抑制药物相关的急性白血病的所有报道，并讨论了其可能的机制。这表明，类风湿性关节炎患者与硫唑嘌呤和烷化剂治疗可能有一个治疗相关的急性白血病的风险增加。
Acute leukemia is described in two patients treated with cytotoxic agents for a destructive, seropositive rheumatoid arthritis. Both patients had received longterm azathioprine therapy. In addition, one patient had been treated with cyclophosphamide, the other with melphalan. Chromosomal abnormalities were noted in both patients. Studies in one patient included colony forming units, ferrokinetics, electron microscopy of bone marrow, and autopsy examination. All reports of acute leukemia associated with cytostatic drugs in the literature to date are reviewed and the possible mechanisms discussed. It is suggested that patients with rheumatoid arthritis treated with azathioprine and alkylating agents may have an increased risk of developing a therapy-related acute leukemia.