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作 者:展世宏[1] 成芳芳[1] 缪洁 凌婧[1] 何海龙[1] ZHAN Shihong;CHENG Fangfang;MIAO Jie;LING Jing;HE Hailong(Children's Hospital of Soochow University,Suzhou 215000,Jiangsu,China)
出 处:《临床儿科杂志》2019年第3期170-172,共3页Journal of Clinical Pediatrics
基 金:国家自然科学基金资助(No.81500107;81700165)
摘 要:目的分析先天性白血病的临床特征和诊治要点。方法回顾分析2012年9月至2017年4月收治的14例先天性白血病患儿的临床资料。结果 14例患儿中男8例、女6例,9例生后1周内即发病。临床主要表现为皮肤出血点4例、脐部渗血1例、皮疹3例、皮肤黄染5例、呼吸急促4例、腹泻1例、发热1例;10例出现肝脾肿大;7例确诊21-三体综合征。14例患儿外周血白细胞均明显增高,伴有贫血6例,伴有血小板减少6例;骨髓检查及血涂片均见幼稚细胞,且多为急性髓细胞性白血病。14例患儿均未选择化疗。7例失访;5例短时间内死亡,生存时间小于1个月;2例21-三体综合征患儿目前自然缓解中。结论先天性白血病发展迅速,但也可能自然缓解。Objective To explore the clinical features, diagnosis and treatment of congenital leukemia. Method The clinical data of congenital leukemia in 14 children admitted from September 2012 to April 2017 were retrospectively analyzed. Results In 14 patients (8 boys and 6 girls), the age at the onset was within 1 week after birth in 9 patients. The main clinical manifestations were skin bleeding spots (4 cases), umbilical bleeding (1 case), skin rash (3 cases), jaundice (5 cases), shortness of breath (4 cases), diarrhea (1 case) and fever (1 case). Ten patients had hepatosplenomegaly and 7 were diagnosed with trisomy 21 syndrome. Leukocyte count in peripheral blood increased significantly in 14 children, anemia in 6 cases and thrombocytopenia in 6 cases. Bone marrow examination and blood smears of the children showed immature cells, most of which were acute myeloid leukemia. None of the 14 patients chose to have chemotherapy. Seven patients were lost to follow-up. Five patients died within a short time and the survival time was less than 1 month. Two children with trisomy 21 syndrome were currently in spontaneous remission. Conclusion Congenital leukemia develops rapidly, but it may also spontaneously alleviate.
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