本文描述1例慢性粒细胞性白血病(CML)超过30个月的慢粒期,无任何急变体征而伴有股骨头坏死。本例的特点有:一是此为首例CML以股骨头坏死为表现者,二是尽管有破坏性骨损害存在而患者仍长期处于慢粒期。患者男性,17岁,1980年9月以右髋部疼痛4个月发病。过去无髓部疾病和外伤史。体检右股骨头大转子处明显触痛及向各方面转动时剧痛。脾肿大左肋下4cm,余无异常。最初右髋部X线示股骨头硬化,边缘不规则,碎裂样改变,符合缺血性坏死表现。血液学检查呈典型CML。血红蛋白161g/L,白细胞116×10~9/L。分类:偶见原始细胞,早幼粒2%,中幼粒6%,晚幼粒6%,带状核9%,分叶核66%,淋巴3%,嗜酸性4%,嗜碱性4%。血小板319×10~9/L。中性粒细胞碱性磷酸酶积分2(正常14～60)。骨髓检查呈增生极度活跃,粒细胞明显增 This article describes a chronic granulocytic leukemia (CML) more than 30 months of the slow grain stage, without any signs of acute necrosis associated with femoral head. The characteristics of this example are: First, this is the first CML to show the performance of the femoral head necrosis, and second, despite the existence of destructive bone damage in patients with chronic long-term remain in the grain stage. The patient, male, 17 years old, developed right hip pain for 4 months in September 1980. Past history of myeloid disease and trauma. Physical examination right femoral head greater trochanter tenderness and pain in all aspects of rotation. Splenomegaly left rib 4cm, I no exception. The first right hip X-ray showed femoral head sclerosis, irregular edges, fragmentation-like changes, in line with the performance of ischemic necrosis. Hematology examination showed typical CML. Hemoglobin 161g / L, white blood cells 116 × 10 ~ 9 / L. Category: Occasionally primitive cells, promyelocytic 2%, juvenile 6%, late juvenile 6%, ribbon 9%, lobulated 66%, lymph 3%, 4% acidophilic, basophilic 4 %. Platelets 319 × 10 ~ 9 / L. Neutrophil alkaline phosphatase score 2 (normal 14 ~ 60). Bone marrow examination was extremely active hyperplasia, granulocytes significantly increased