bloodjourГематология и трансфузиологияRussian journal of hematology and transfusiology0234-57302411-3042ООО Издательский дом «Практика»10.35754/0234-5730-2020-65-4-501-513bloodjour-246Research ArticleКЛИНИЧЕСКИЕ НАБЛЮДЕНИЯCASE REPORTSРазвитие множественной миеломы и хронического миелолейкоза у одной больнойCoexistence of multiple myeloma and chronic myeloleukosis in one patienthttps://orcid.org/0000-0002-9531-1025РыбинаО. В.RybinaO. V.

Ольга Валерьевна Рыбина, врач-гематолог отделения гематологии

129128, Москвател.: +7 (985) 267-20-12

Olga V. Rybina, Haematologist, Department of Haematology

129128, Moscowtel.: +7 (985) 267-20-12

Olia.fishka@yandex.ruhttps://orcid.org/0000-0003-4395-1968ШавельЮ. А.ShavelJ. A.

Юлия Александровна Шавель, врач-гематолог высшей квалификационной категории отделения гематологии

129128, Москва

Jylia A. Shavel, Haematologist (higher degree), Department of Haematology

129128, Moscow

gematdoc@gmail.comhttps://orcid.org/0000-0001-8461-5421ПетренкоА. А.PetrenkoA. A.

Андрей Анатольевич Петренко, врач-гематолог

125284, Москва

Andrei A. Petrenko, Haematologist

125284, Moscow

petrenkoandrei13@gmail.comhttps://orcid.org/0000-0002-5375-0273ГалайкоМ. В.GalaikoM. V.

Мария Владимировна Галайко, врач-гематолог отделения гематологии

129128, Москва

Marya V. Galaiko, Haematologist, Department of Haematology

129128, Moscow

loima@mail.ruhttps://orcid.org/0000-0001-7134-3893ЛитвиненкоМ. С.LitvinenkoM. S.

Мария Сергеевна Литвиненко, врач-гематолог отделения гематологии

129128, Москва

Marya S. Litvinenko, Haematologist, Department of Haematology

129128, Moscow

maryasergeevnal@yandex.ruhttps://orcid.org/0000-0003-0298-072XЕгорковВ. Е.EgorkovV. E.

Владимир Евгеньевич Егорков, врач-гематолог отделения гематологии

129128, Москва

Vladimir E. Egorkov, Haematologist, Department of Haematology

129128, Moscow

ckb2gem@mail.ruhttps://orcid.org/0000-0003-3698-7751ГубкинА. В.GubkinA. V.

Андрей Владимирович Губкин, кандидат медицинских наук, главный гематолог Центральной дирекции здравоохранения–филиала ОАО «РЖД», заведующий отделением, ЧУЗ «Центральная клиническая больница «РЖД-Медицина»

129128, Москва

Andrey V. Gubkin, Cand. Sci. (Med.), Chief Haematologist, Central Healthcare Directorate–Branch of “OAO RZhD”, Head of the Department of Haematology, Central Clinical Hospital “RZD-Medicine”

129128, Moscow

gubkinav@gmail.comЧУЗ «Центральная клиническая больница «РЖД-Медицина»РоссияCentral Clinical Hospital “RZD-Medicine”Russian FederationГБУЗ г. Москвы Городская клиническая больница им. С. П. Боткина Департамента здравоохранения г. МосквыРоссияBotkin Moscow City HospitalRussian Federation202009122020654501513Copyright © Рыбина О.В., Шавель Ю.А., Петренко А.А., Галайко М.В., Литвиненко М.С., Егорков В.Е., Губкин А.В., 20202020Рыбина О.В., Шавель Ю.А., Петренко А.А., Галайко М.В., Литвиненко М.С., Егорков В.Е., Губкин А.В.Rybina O.V., Shavel J.A., Petrenko A.A., Galaiko M.V., Litvinenko M.S., Egorkov V.E., Gubkin A.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.htjournal.ru/jour/article/view/246Введение

Введение. Множественная миелома (ММ) и хронический миелолейкоз (ХМЛ) — два гематологических заболевания, возникающие вследствие опухолевой трансформации лимфоидной и миелоидной клеток-предшественниц и не имеющие общую клетку-предшественницу. Оба заболевания крайне редко встречаются у одного больного.

Цель — описать клиническое наблюдение больной, у которой через несколько месяцев после начала лечения ММ был выявлен ХМЛ.

Основные сведения

Основные сведения. Представлено клиническое наблюдение диагностики ММ и ХМЛ у одной больной в возрасте 62 лет. Первично диагностирована ММ, проведено 5 курсов по программе VD. В связи с выраженной полинейропатией лечение было прекращено. Больная была переведена на поддерживающую терапию талидомидом. Через 12 месяцев от начала терапии талидомидом был диагностирован ХМЛ BCR-ABL (p190) и BCR-ABL (р210). Проводилась терапия иматинибом, с кратковременным эффектом, в дальнейшем переведена на терапию дазатинибом. Через 16 месяцев от начала терапии дазатинибом диагностирован рецидив ММ и прогрессия ХМЛ.

Intoduction

Intoduction. Multiple myeloma (MM) and chronic myelogenous leukaemia (CML) are two haematological malignancies developing through tumour transformation of lymphoid and myeloid progenitor cells, respectively, not sharing a common ancestry. Coexistence of the two diseases is extremely rare.

Aim

Aim. Clinical description of a patient diagnosed with CML in a few months after start of MM therapy.

Main findings

Main findings. We report a clinical case of MM and CML in a 62 years-old female patient. MM was diagnosed newly and followed by 5 VD chemotherapy cycles. Treatment discontinued due to severe polyneuropathy. The patient was transferred to thalidomide maintenance therapy. CML was diagnosed 12 months after initiation of thalidomide therapy: BCR-ABL (p190), BCR-ABL (p210). Since imatinib produced short-term effect, dasatinib therapy was started. Following 16 months after the onset of dasatinib therapy, MM relapse and CML progression were diagnosed.

множественная миеломахронический миелолейкозингибиторы тирозинкиназыхимиотерапиялучевая терапияmultiple myelomachronic myeloid leukaemiatyrosine kinase inhibitorschemotherapyradiation therapyАвторы выражают благодарность коллективу клинико-диагностической лаборатории ЧУЗ «Центральная клиническая больница «РЖД-Медицина» и сотрудникам ФГБУ «Национальный медицинский исследовательский центр гематологии» Министерства здравоохранения Российской Федерации за помощь в проведении исследования.The authors are grateful to the team of the Clinical and Diagnostic Laboratory at the Central Clinical Hospital “RZD-Medicine” and staff of the National Research Center for Hematology, Ministry of Health of the Russian Federation, for help in conducting research.ReferencesПоддубная И.В., Савченко В.Г. Российские клинические рекомендации по диагностике лечению лимфопролиферативных заболеваний. М., 2019.Poddubnaya I.V., Savchenko V.G. 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The authors declare that there are no conflicts of interest present.