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目的探讨非白血病性粒细胞肉瘤的临床特点和治疗方法。方法回顾性分析12例非白血病性粒细胞肉瘤患者的临床资料,其中手术或放疗联合化疗5例,单纯化疗4例,自体干细胞移植1例,放疗加手术1例,单纯手术1例。化疗的患者均采用类似治疗非霍奇金淋巴瘤的方案(CHOP或DICE方案)。5例曾误诊为非霍奇金淋巴瘤,免疫组化检查后明确诊断。结果随访期间5例患者在治疗后由非白血病性粒细胞肉瘤转化为急性髓系白血病(AML),其中未接受化疗者2例,即只接受了局部手术或放疗者均转化为AML,由非白血病性粒细胞肉瘤转化为急性髓系白血病的中位间隔时间为6个月(3～10个月)。12例患者中位生存时间为11个月(4～35个月)。结论非白血病性粒细胞肉瘤误诊率高,免疫组化对于明确诊断十分重要;宜采用强有力的抗白血病样的化疗方案进行治疗以提高其生存率。
Objective To investigate the clinical features and treatment of non-leukemia granulocystic sarcoma. Methods The clinical data of 12 patients with non-leukemic granulocystic sarcoma were retrospectively analyzed. Among them, 5 cases were treated with chemotherapy or radiotherapy combined with chemotherapy, 4 cases received chemotherapy alone, 1 case received autologous stem cell transplantation, 1 case received radiotherapy plus surgery, and 1 case received surgery alone. Patients on chemotherapy were treated with a similar regimen of non-Hodgkin’s lymphoma (CHOP or DICE regimen). 5 cases were misdiagnosed as non-Hodgkin’s lymphoma, a clear diagnosis after immunohistochemistry. Results During the follow-up period, 5 patients were converted from non-leukemia granulocytic sarcoma to acute myeloid leukemia (AML). Among 2 patients who did not receive chemotherapy, only 5 patients underwent local surgery or radiotherapy were converted to AML, The median interval for leukemic granulocytic sarcoma to acute myeloid leukemia was 6 months (3 to 10 months). The median survival time in 12 patients was 11 months (range 4-35 months). Conclusions The misdiagnosis rate of non-leukemia granulocytic sarcoma is very high. Immunohistochemistry is very important for definite diagnosis. It should adopt powerful anti-leukemia-like chemotherapy regimen to improve its survival rate.