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1875年,William Peper首先描述了1例致死性恶性贫血——一种假性白血病的骨髓情况。本世纪初,Minot和Murphy经几个月每日服用牛肝脏后治好了45例恶性贫血患者。最后证实维生素B_(12)是一种未被认识的诱导分化剂。持续用维生素B_(12)治疗可缓解恶性贫血的临床表现但非治愈疾病本身。 25年前,在未治疗的恶性贫血病人中发现了一些也可出现在其它恶性肿瘤中的染色体异常包括染色体异位等。这些染色体异常在用维生素B_(12)治疗时消失,而当停止治疗时又再出现。 Castaigne等和Chomienne等展示了一些戏剧性的证据表明。在一种类型急性白血病-急性早幼粒细胞性白血病(APL)可能正重复类似于恶性贫血的例证。据他们报告。14/22例复发期APL病人口服全反式维甲酸(aRA)后达到了完全缓解(CR),aRA用90天后停止。部分病人的CR期较短仅数月而另一些病人的CR期可持续1年或更长。治疗前,20/
In 1875 William Peper first described one case of fatal pernicious anemia, a myeloid bone marrow condition. At the beginning of this century, Minot and Murphy cured 45 patients with pernicious anemia after taking beef liver for several months daily. Finally confirmed that vitamin B_ (12) is an unidentified inducer of differentiation. Continued with vitamin B_ (12) treatment can alleviate the clinical manifestations of pernicious anemia but not cure the disease itself. Twenty-five years ago, chromosomal abnormalities, including chromosomal abnormalities, that could also occur in other malignancies were found in untreated patients with pernicious anemia. These chromosomal abnormalities disappeared when treated with vitamin B_ (12) and reappeared when treatment was discontinued. Castaigne et al. And Chomienne et al. Show some dramatic evidence. In one type of acute leukemia, acute promyelocytic leukemia (APL), may be repeating an example of pernicious anemia. According to them report. Complete remission (CR) was achieved in 14/22 patients with relapsed APL after oral all-trans retinoic acid (aRA), with aRA discontinued after 90 days. Some patients have a shorter CR period of only a few months and others have a CR period of one year or longer. Before treatment, 20 /