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作者在1例甲状腺髓质癌伴转移的病人,证实其体内有一种因子能促使多能造血祖细胞向嗜酸细胞分化,其结果可能消耗病人的造血干细胞,并延长细胞毒药物所引起的骨髓抑制。嗜酸细胞计数变化与肿瘤负荷相平行,可作为病程进展的一个可靠标记。病例男,61岁,因嗜酸细胞增多2个月入院。3年前病人血常规检查白细胞9 300/μl,嗜酸细胞(E)1%。入院体查发现一侧颈有5×3cm 肿块,血红蛋白12.8g/dl,白细胞1×10~5/μl,E96%。骨髓增生伴 E 增殖。淋巴结活检为甲状腺髓质癌。放射性核素扫描见肝广泛转移。入院前曾用强的松60mg/d,未能使嗜酸细胞减少。入院后用氮烯咪胺(dacarba-zine)250mg/M~2/d 静注,连用5天。原计划每3周化疗一次,因持续白细胞下降无法实施。在2个疗程
In one patient with metastatic thyroid carcinoma, one of the factors in the body was demonstrated to promote the differentiation of pluripotent hematopoietic progenitor cells into eosinophils, which could result in depletion of the patient’s hematopoietic stem cells and prolongation of the bone marrow caused by cytotoxic drugs inhibition. Eosinophil counts parallel to tumor burden can be used as a reliable marker of disease progression. Male, 61 years old, admitted to hospital for 2 months due to eosinophilia. 3 years ago, the patient’s routine examination of white blood cells 9 300 / μl, eosinophils (E) 1%. Admission found on one side of the neck neck 5 × 3cm mass, hemoglobin 12.8g / dl, white blood cells 1 × 10 ~ 5 / μl, E96%. Myeloproliferation with E proliferation. Lymph node biopsy is medullary thyroid cancer. Radionuclide scan showed extensive liver metastasis. Had used prednisone 60mg / d before admission, failed to make eosinophils decreased. Admission with dacarbba-zine 250mg / M ~ 2 / d intravenous, once every 5 days. The original plan once every 3 weeks of chemotherapy, because of persistent leukopenia can not be implemented. In 2 courses