好中球増多症の経過中，多発性骨髄腫を合併し６年後に急性単球性白血病（ＡＭＬ，Ｍ５ｂ）を発症した１症例

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A case of a 70 years old female who developed multiple myeloma during a course of neutrophilia, and later on terminated with acute monocytic leukemia (AML, M5b) following Melphalan therapy for five years is reported.This patient was first found to have neutrophilia in 1966, After six years, she developed monoclonal gammopathy, (IgG1 κ type) which coexisted with the neutrophilia.She was put on Melphalan regimen for 5 years which was discontinued due to anemia, leukocytopenia and the reduction of serum IgG. By routine bone marrow examination, she was diagnosed as AMoL (AML, M5b) in July 1984.Thereafter, a combination chemotherapy of BH-AC, 6-MP and prednisolone was started and complete remission for the AMoL was achieved after 2 months. Sixteen months later, she relapsed and a similar combination chemotherapy for reinduction regimen was administered. However, the AMoL was resistant and after 7 months, she died of pneumonia and multiple organ failure. The association of neutrophilia with multiple myeloma, the occurrence of AMoL after prolonged Melphalan therapy for the multiple myeloma and the strategy of therapy for secondary leukemia is discussed.
一般社団法人日本血液学会の論文