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NEJM：Auer小体-案例报道

2017-05-25 xing.T MedSci原创

Auer小体白血病APL
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这种形式的白血病与弥散性血管内凝血的发生有关，这种风险可以通过全反式维甲酸的早期治疗来减轻。该患者完成全反式维甲酸和三氧化二砷诱导和巩固治疗，并在后续10个月后在分子层面上得到了完全的缓解。

患者为一名69岁的男性，因中性粒细胞减少症和贫血的评估和治疗而转诊至研究人员所在的医疗中心。血常规显示白细胞计数每微升1000（参考范围为4800到10800每微升），其中中性粒细胞为10%（中性粒细胞绝对计数为100），血红蛋白水平为10.6克每分升（参考范围为14到18克每分升）。骨髓穿刺结果显示5%的幼稚和65%的早幼粒细胞；许多细胞有明显的Auer小体（如箭头所示）和有丝分裂像。


患者开始接受全反式维甲酸治疗。荧光原位杂交显示易位涉及15和17号染色体，导致融合蛋白产生，早幼粒细胞白血病-视黄酸受体α，这证实了急性早幼粒细胞白血病（APL）的诊断。Auer小体可在大多数急性髓系白血病亚型中见到，但当看到这种小体较多时，往往提示为APL。

这种形式的白血病与弥散性血管内凝血的发生有关，这种风险可以通过全反式维甲酸的早期治疗来减轻。该患者完成全反式维甲酸和三氧化二砷诱导和巩固治疗，并在后续10个月后在分子层面上得到了完全的缓解。

原始出处：

Sarah W. Gordon,et al. Auer Rods.N Engl J Med 2017; http://www.nejm.org/doi/full/10.1056/NEJMicm1612344

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  1. [GetPortalCommentsPageByObjectIdResponse(id=202613, encodeId=039820261375, content=不错的报道，学习了。, beContent=null, objectType=article, channel=null, level=null, likeNumber=1, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/5s91rMfm6qvY69RmicgQoiadpG5Djkdl1h3QrsGylJnQHFNiaQz1HvqgV2QCQD6kVnb15swwZFYjZhVWmOv3AOQrQ/132, createdBy=6c5c2055186, createdName=七堇, createdTime=Fri May 26 05:58:16 CST 2017, time=2017-05-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=202368, encodeId=85c8202368f2, content=学习啦谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLK1wzJZRTON4gxYUibhUyOypBwMibC4R7SsppicGhz5Ogoy0VVq4CWnqaD2Moeib8RWxI5lOiaVmnxpan/0, createdBy=c53f1730331, createdName=tanxingdoctor, createdTime=Thu May 25 09:34:30 CST 2017, time=2017-05-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=202328, encodeId=29f620232807, content=学习一下很不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=86, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/23/ac01daf0962458a9eb8c0b1e2f6ce5bc.jpg, createdBy=04b81710322, createdName=1771ae4158m, createdTime=Thu May 25 08:20:21 CST 2017, time=2017-05-25, status=1, ipAttribution=)]
    2017-05-26 七堇

    不错的报道，学习了。

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=202613, encodeId=039820261375, content=不错的报道，学习了。, beContent=null, objectType=article, channel=null, level=null, likeNumber=1, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/5s91rMfm6qvY69RmicgQoiadpG5Djkdl1h3QrsGylJnQHFNiaQz1HvqgV2QCQD6kVnb15swwZFYjZhVWmOv3AOQrQ/132, createdBy=6c5c2055186, createdName=七堇, createdTime=Fri May 26 05:58:16 CST 2017, time=2017-05-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=202368, encodeId=85c8202368f2, content=学习啦谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLK1wzJZRTON4gxYUibhUyOypBwMibC4R7SsppicGhz5Ogoy0VVq4CWnqaD2Moeib8RWxI5lOiaVmnxpan/0, createdBy=c53f1730331, createdName=tanxingdoctor, createdTime=Thu May 25 09:34:30 CST 2017, time=2017-05-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=202328, encodeId=29f620232807, content=学习一下很不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=86, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/23/ac01daf0962458a9eb8c0b1e2f6ce5bc.jpg, createdBy=04b81710322, createdName=1771ae4158m, createdTime=Thu May 25 08:20:21 CST 2017, time=2017-05-25, status=1, ipAttribution=)]
    2017-05-25 tanxingdoctor

    学习啦谢谢分享

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=202613, encodeId=039820261375, content=不错的报道，学习了。, beContent=null, objectType=article, channel=null, level=null, likeNumber=1, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/5s91rMfm6qvY69RmicgQoiadpG5Djkdl1h3QrsGylJnQHFNiaQz1HvqgV2QCQD6kVnb15swwZFYjZhVWmOv3AOQrQ/132, createdBy=6c5c2055186, createdName=七堇, createdTime=Fri May 26 05:58:16 CST 2017, time=2017-05-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=202368, encodeId=85c8202368f2, content=学习啦谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLK1wzJZRTON4gxYUibhUyOypBwMibC4R7SsppicGhz5Ogoy0VVq4CWnqaD2Moeib8RWxI5lOiaVmnxpan/0, createdBy=c53f1730331, createdName=tanxingdoctor, createdTime=Thu May 25 09:34:30 CST 2017, time=2017-05-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=202328, encodeId=29f620232807, content=学习一下很不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=86, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/23/ac01daf0962458a9eb8c0b1e2f6ce5bc.jpg, createdBy=04b81710322, createdName=1771ae4158m, createdTime=Thu May 25 08:20:21 CST 2017, time=2017-05-25, status=1, ipAttribution=)]
    2017-05-25 1771ae4158m

    学习一下很不错

    0

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