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USING VAD TO TREAT ALL ACCOMPANY WITH HYPERLEUKOCYTOSIS (A CASE REPORT AND LITERATURE REVIEW)
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- Author:
- No author available
- Journal Title:
- JOURNAL OF LEUKEMIA & LYMPHOMA
- Issue:
- 6
- DOI:
- 10.3760/cma.j.issn.1009-9921.2003.06.005
- Key Word:
- 急性淋巴细胞性白血病;DIC;高白细胞综合征;VAD
Abstract： 目的:报道1例初诊急性淋巴细胞性白血病(ALL)患者合并弥漫性血管内凝血(DIC)及高白细胞综合征,经VAD方案化疗并及时纠正DIC治疗后完全缓解(CR),并进行文献复习.方法:1例初诊ALL患者,41岁男性,诊断时伴有高白细胞综合征多脏器浸润(WBC392×109/L)DIC、低氧血症、大量腹水及心肌酶、尿酸明显升高,骨髓穿刺:增生极度活跃,原+幼淋89.5%,提示ALL.入院后立即予VAD方案化疗,同时水化、碱化尿液、利尿,小剂量肝素持续静点及间断输注纤维蛋白原纠正DIC.结果:患者临床症状明显好转,血象、凝血功能、D-二聚体、肝、肾功能、血气、心肌酶等亦逐渐恢复正常,复查骨髓示:原+幼淋占1%,ALL-CR.结论:VAD方案中大剂量激素可达到快速减低肿瘤负荷的目的,且激素不引起大量肿瘤细胞崩解,较少发生溶瘤综合征.对高白细胞性ALL有较好的治疗效果.
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