儿童尤文肉瘤治疗后继发急性髓系白血病1例并文献复习

A Case of Acute Myeloid Leukemia Secondary to Ewing Sarcoma Treatment in Children and Literature Review

摘要: 目的：探讨尤文肉瘤(Ewing Sarcoma, ES)治疗后发生急性髓系白血病(Acute Myelogenous Leukemia, AML)的临床特征及预后，提高对继发急性髓系白血病的认识。方法：回顾性分析山东省青岛大学附属医院收治的1例原发于脊柱ES治疗后继发AML的诊疗情况，并复习相关文献。结果：患儿采用放化疗 + 局部手术治疗方式进行治疗，化疗结束后6月，放疗结束后4月后出现肌肉酸痛，伴全身散在出血点等，行骨髓穿刺术诊断为急性髓系白血病，因生命体征持续不稳定，经抢救无效后死亡。结论：ES治疗后继发白血病多为急性髓系白血病。且常起病急，预后差，临床上需对于有放化疗治疗的患儿进行定期随诊，以对第二肿瘤进行早期筛查，改善预后。

Abstract: Objective: To explore the clinical features and prognosis of Acute Myelogenous Leukemia (AML) af-ter treatment of Ewing Sarcoma (ES), and to improve the recognition of secondary acute myeloid leukemia (AML). Methods: The diagnosis and treatment of a case of secondary AML after spinal ES treatment in the Affiliated Hospital of Qingdao University in Shandong Province were retrospec-tively analyzed, and the related literature was reviewed. Results: The patient was treated with ra-diotherapy and chemotherapy plus local surgery. 6 months after the end of chemotherapy and 4 months after the end of radiotherapy, muscle soreness and bleeding points were scattered throughout the body. Bone marrow puncture was performed and diagnosed as acute myeloid leu-kemia. Conclusion: Acute myeloid leukemia is the secondary leukemia after ES treatment. It often has an acute onset and poor prognosis. It often has an acute onset and poor prognosis, so it is clini-cally necessary to conduct regular follow-up for children treated with radiotherapy and chemo-therapy to conduct early screening of the second tumor and improve the prognosis.