急性早幼粒细胞白血病治疗前血象与预后分析

Analysis of the Pretreatment Hemogram Changes and Its Relation to Prognosis of Patients With Acute Promyelocytic Leukemia

目的：探讨急性早幼粒细胞白血病（APL）患者治疗前外周血白细胞计数变化规律与预后的关系。方法：总结12例首诊时被误诊为其他疾病（或急性白血病的其他类型），最后在我科确诊为APL的患者首诊及确诊时血象、凝血功能变化及转归。结果：首诊至确诊为APL的时间4～45d不等，平均13．4d。9例确诊时WBC计数较首诊时升高，3例下降。首诊和确诊时平均WBC计数分别为5．13×10^9／L、25．16×10^9／L。经治疗后5例死亡，均在诱导治疗期间死于颅内出血，其余7例至今均为持续完全缓解（CCR）状态。结论：APL发病早期，患者外周血WBC计数多低于正常，以后，WBC计数可逐渐升高，凝血功能紊乱及出血倾向亦渐加重，患者的预后也明显变差。

Objective：To explore the changes of WBC count of peripheral blood in patients with acute promyelo cytic leukemia （APL） before treatment and its correlation with prognosis. Methods： All the data of the misdiagnosed patients who were confirmed as APL afterwards in our hospital were collected for a retrospective study. Re suits： The time from first visit to final diagnosis as APL was 4 to 45 days, with average of 13.4 days. WBC counts in 9 cases was higher at the time of diagnose as APL than that at first visit, while 3 was lower at the time of confirmation as APL. The average WBC counts of patients at the time of first visit and confirmation of diagnosis as APL was 5. 13×10^9/L and 25.16×10^9/L respectively. Five of the cases died of intracranial hemorrhage during induction therapy, the others had been in continuous complete remission （CCR） so far. Conclusion： WINg count was lower than normal values in the early stage of APL. With the delay of diagnosis, the WBC count becomes higher, the impaired coagulation function more prominant, and the prognosis of the patients get worse obviously.