高白细胞性急性白血病51例临床研究

Clinical study on 51 patients with hyperleukocytic acute leukemia

目的探讨高白细胞性急性白血病(HAL)的临床特征、治疗效果及预后分析。方法对51例HAL进行临床回顾性分析,同时以482例非高白细胞性急性白血病(NHAL)作对照组。结果HAL构成比为9.62%;HAL组的髓外浸润、DIC、白细胞淤滞综合征及早期死亡率较对照组高。HAL组完全缓解率为31.4%低于NHAL的58.1%。HAL组早期死亡率是21.6%,早期死亡的主要原因是颅内出血和呼吸窘迫综合征。HAL完全缓解率和早期死亡率与FAB的分型有关。结论HAL完全缓解率低,早期死亡率高,预后差。

Objective To investigate the clinical characteristics,therapeutic effects and the prognostic factors of patients with hyperleukocytic acute leukemia （HAL）.Methods Reviewed 51 patients with acute leukemia characterized with hyper-leukocytosis and 482 cases of non- hyperleukocytic acute leukemia （NHAL）.Results HAL occurred in 9.62% of patients with acute leukemia. Compared to NHAL ,HAL had a high incidence of outer marrow infiltration,leukocyte stasis syndrome,DIC and early mortality rate. The complete remission rate was 31.4% for patients with hyperleukocytosis versus 58.1% for patients with non- hyperleukocytosis.The early mortality rate was 21.6% in HAL .Intracranial hemorrhage and ARDS were the main causes of early death. The complete remission rate and early mortality rate of the HAL were in correlation with FAB subtypes. Conclusion HAL patients have poor prognosis, low complete remission and high early mortality rate.