急性儿童高白细胞白血病诊疗分析  

Diagnosis and treatment of children with hypercytic acute leukemia

作　　者：廉国利[1] 吴红艳[1] 丁玎[1] 何敏[1] 刘志刚[1] 

机构地区：[1]西安交通大学医学院第一附属医院儿科,陕西西安710061

出　　处：《中国妇幼健康研究》2013年第4期567-568,583,共3页Chinese Journal of Woman and Child Health Research

摘　　要：目的探讨儿童高白细胞白血病的临床特征、免疫表型分型和治疗效果。方法回顾分析初发高白细胞白血病患儿18例的临床资料,通过MICM相关检测进行分型、诊断、治疗及效果分析。结果在18例高白细胞白血病中,急性淋巴细胞白血病14例,急性非淋巴细胞白血病3例,急性粒淋混合细胞白血病1例。有4例确诊后放弃治疗,其余14例进行了充分水化、碱化并进行了小剂量化疗和诱导缓解治疗,有11例患儿诱导缓解治疗后在1个月内完全缓解,无因早期并发症死亡病例。有1例急性淋巴细胞白血病患儿现已完成全部化疗停药,9例现仍在继续治疗中,复发4例,其中2例急性非淋巴细胞白血病患儿化疗后1年发生复发死亡。结论高白细胞白血病经积极规范化治疗并及时处理化疗中的各种并发症,可使患儿获得完全缓解,高白细胞急性非淋巴细胞白血病患儿预后差,易复发,并且可发生中枢神经系统白血病,要提前重视并及早预防。Objective To discuss the clinical characteristics, immune type and treatment effect of children with hypercytic acute leukemia （HAL）. Methods Retrospective analysis was conducted on clinical data of 18 cases of children with HAL. Typing, diagnosis, treatment and effect analysis were done according to MICM. Results There were 14 cases of acute lymphoblastic leukemia（ ALL）, 3 cases of acute non-lymphocytic leukemia（ANLL） and 1 case of acute granular lymphocyte hybrid leukemia. Except for 4 cases giving up treatment after definite diagnosis, the other 14 cases were given vigorous hydration, alkalinization, low dose of chemotherapy and remission induction. There were 11 cases obtaining complete remission within 1 month, and none of the 14 patients developed life-threatening complication. One case had finished all of the chemotherapy, another 9 cases still continued the treatment, and the left 4 patients relapsed including 2 of them died after 1 year of chemotherapy. Conclusion After the standard therapy and handling the complications in time, the children with HAL can completely relieve. Children with hypercytic NALL have poor prognosis and easy recurrence. Meanwhile, they may develop central nervous system leukemia, so attention and prevention should be considered.

关 键 词：高白细胞急性白血病 儿童 死亡率 预后 

分 类 号：R733.7[医药卫生—肿瘤] R72[医药卫生—临床医学]