問題詳情

167. 一位75歲男士,過去無特殊病史,在例行抽血檢查時發現Hb 9.2 gm/dL,WBC 2600/μL,blasts2%,segmented neutrophils 35%,monocytes 8%,lymphocytes 55%,血小板23000/μL;骨髓檢查顯示造血細胞化生不良(dysplasia),blasts 9%,染色體為複雜變化。此病人最適當的治療為何?
(A) Packed RBC transfusion
(B) Platelet concentrate transfusion
(C) Erythropoietin
(D) Azacitidine
(E) Allogeneic hematopoietic stem cell transplantation

參考答案

答案:D
難度:適中0.455
書單:沒有書單,新增

用户評論

.】評論

由flow chart 會偏向bone marrow hypoplasia, 接下來則會以IPSS-R計算為超過分6,為high risk; No particular cytoreductive bridging therapy has been shown to achieve superior outcomes following transplantation. However, a retrospective study of bridging therapy reported that, compared with intensive chemotherapy, treatment with azacitidine achieved a comparable rate of post-transplant relapse, but caused less toxicity [21]. In another study, outcomes were comparable whether pretransplant bridging therapy was azacitidine alone, intensive remission induction therapy alone, or azacitidine followed by intensive remission induction therapy [22]. Other studies reported that survival after allogeneic HCT was comparable whether patients proceeded directly to transplantation or received intensive remission induction therapy prior to allogeneic HCT ;依上文雖azacitidine較易有移植後復發,但依病人年紀大,仍考慮使用毒性較弱的azacitidine