Malignant clonal evolution from high proportion of monocytes in patients with aplastic anemia: a case report.

Q1 Biochemistry, Genetics and Molecular Biology
Qiuhao Fu, Lingling Liu, Yingmei Li
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引用次数: 0

Abstract

Background: Aplastic anemia (AA) is a heterogeneous group of hematopoietic failure diseases, characterized mainly by immune hyperfunction, impaired immune tolerance, the hematopoietic microenvironment, and hematopoietic stem or progenitor cell deficiency. Oligoclonal hematopoiesis and clonal evolution make the disease more complicated, and extremely challenging to diagnose. After immunosuppressive therapy (IST) and granulocyte colony-stimulating factor (G-CSF) treatment, AA patients have a risk of developing acute leukemia.

Case description: Here we report a patient with a relatively high proportion of monocytes, and all other tests were consistent with severe aplastic anemia (SAA). Monocytes increased rapidly after G-CSF treatment and were eventually diagnosed as hypo-hyperplastic acute monocytic leukemia 7 months later. A high proportion of monocytes may predict malignant clonal evolution in patients with AA. In combination with the literature, we recommend paying close attention to monocytes' elevation in patients with AA for clonal evolution and accurately selecting treatment options.

Conclusions: The proportion of monocytes in the blood and bone marrow of AA patients should be closely monitored. Hematopoietic stem cell transplantation (HSCT) should be performed as early as possible once monocytes continue to increase or are associated with phenotypic abnormalities or genetic mutations. The unique value of this study is that although there were case reports about AA-derived acute leukemia, we suggested that an early high proportion of monocytes may predict malignant clonal evolution in patients with AA.

再生障碍性贫血患者高比例单核细胞恶性克隆进化1例报告。
背景:再生障碍性贫血(AA)是一种异质性的造血功能衰竭疾病,其主要特征是免疫功能亢进、免疫耐受受损、造血微环境和造血干细胞或祖细胞缺乏。低克隆造血和克隆进化使得疾病更加复杂,诊断极具挑战性。在免疫抑制治疗(IST)和粒细胞集落刺激因子(G-CSF)治疗后,AA患者有发生急性白血病的风险。病例描述:在这里,我们报告了一个单核细胞比例相对较高的患者,所有其他检查都符合严重再生障碍性贫血(SAA)。G-CSF治疗后单核细胞迅速增加,7个月后最终诊断为低增生性急性单核细胞白血病。高比例的单核细胞可能预测AA患者的恶性克隆进化。结合文献,我们建议密切关注AA患者的单核细胞升高情况,进行克隆进化,并准确选择治疗方案。结论:应密切监测AA患者血液和骨髓中单核细胞的比例。一旦单核细胞继续增加或与表型异常或基因突变相关,应尽早进行造血干细胞移植(HSCT)。本研究的独特价值在于,尽管有AA源性急性白血病的病例报道,但我们认为早期高比例的单核细胞可能预测AA患者的恶性克隆进化。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Stem cell investigation
Stem cell investigation Biochemistry, Genetics and Molecular Biology-Developmental Biology
CiteScore
5.80
自引率
0.00%
发文量
9
期刊介绍: The Stem Cell Investigation (SCI; Stem Cell Investig; Online ISSN: 2313-0792) is a free access, peer-reviewed online journal covering basic, translational, and clinical research on all aspects of stem cells. It publishes original research articles and reviews on embryonic stem cells, induced pluripotent stem cells, adult tissue-specific stem/progenitor cells, cancer stem like cells, stem cell niche, stem cell technology, stem cell based drug discovery, and regenerative medicine. Stem Cell Investigation is indexed in PubMed/PMC since April, 2016.
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