高白细胞急性早幼粒细胞白血病的临床研究

Clinical study of acute promyelocytic leukemia with high WBC.

目的探讨能有效降低高危急性早幼粒细胞白血病(APL)早期病死率、减少血液和髓外复发的合理治疗方法。方法对APL初诊时高白细胞与非高白细胞患者的临床生物学特征及治疗转归进行回顾性分析和比较。结果29例初诊高白细胞的APL患者占131例初治APL的22.0%,其细颗粒型和CD34^+表达显著增多,早期病死率和复发率亦高于初治白细胞不高的患者。结论初诊高白细胞的APL为高危患者,治疗应个体化,尽早化疗。

Objective To discuss the reasonable therapeutic method to reduce the early death and relapse of acute promyelocytic leukemia （APL） with WBC 〉 10 × 10^9/L. Methods The clinical and molecular characteristics,therapy and outcome were retrospectively analyzed. Results 29（22.0% ）of 131 newly diagnosed APL patients with WBC 〉 10 × 10^9/L were associated with higher occurrences of microgranular variant and CD34 ^＋ expression and inferior outcome compared to those with WBC 〈 10 × 10^9/L. Conclusion Newly-diagnosed APL patients with high WBC are regarded as high risk cases and their treatment should be individualised and as early as possible.