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中华危重症医学杂志(电子版) ›› 2023, Vol. 16 ›› Issue (06) : 520 -522. doi: 10.3877/cma.j.issn.1674-6880.2023.06.014

病例报告

NrasG12D基因阳性的慢性粒单核细胞白血病合并脑梗死一例并文献复习
李芸芸, 吴涛(), 毛东锋, 鱼玲玲, 刘文慧, 梁顺玉   
  1. 730050 兰州,中国人民解放军联勤保障部队第九四〇医院血液科
  • 收稿日期:2023-05-17 出版日期:2023-12-31
  • 通信作者: 吴涛
  • 基金资助:
    甘肃省创新基地和人才计划(甘肃省白血病临床医学研究中心)项目(21JR7RA015)
  • Received:2023-05-17 Published:2023-12-31
引用本文:

李芸芸, 吴涛, 毛东锋, 鱼玲玲, 刘文慧, 梁顺玉. NrasG12D基因阳性的慢性粒单核细胞白血病合并脑梗死一例并文献复习[J]. 中华危重症医学杂志(电子版), 2023, 16(06): 520-522.

慢性粒单核细胞白血病(chronic myelomonocytic leukemia,CMML)是骨髓造血干细胞(hematopoietic stem cells,HSCs)的一种克隆性疾病,被世界卫生组织归类为骨髓增生异常综合征/骨髓增殖性肿瘤(myelodysplastic syndrome/myeloproliferative neoplasm,MDS/MPN)[1]。在欧美国家,几乎90%的病例为60岁以上的患者,中位发病年龄为65 ~ 75岁,以男性为主,发病率为3/10 000 ~ 4/10 000[2-3]。而脑梗死多见于50岁以上的中老年人,常伴有动脉硬化、心房颤动、高血压、糖尿病、血脂异常、脑卒中病史等常见危险因素[4]。CMML合并脑梗死罕见,近期中国人民解放军联勤保障部队第九四〇医院血液科收治一例NrasG12D阳性同时合并脑梗死的CMML青年患者,治疗效果良好,现报道如下。

图1 NrasG12D基因阳性的慢性粒单核细胞白血病合并脑梗死患者骨髓细胞形态(a)及骨髓活检(b)注:a图示单核细胞比例增高;b图示骨髓增生极度活跃,粒、红、巨三系细胞增生伴单核细胞比例增高及巨核细胞形态异常
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