231例急性白血病患儿临床特征比较

Comparison of clinical features of 231 childhood acute leukemia

目的:回顾分析初治急性白血病(AL)儿童临床资料,探讨不同年龄阶段、不同免疫分型的临床特征及治疗情况。方法:将2006年6月至2009年6月231例AL患儿分为Ⅰ组(<3岁)、Ⅱ组(3～9岁)、Ⅲ组(9～14岁),比较性别、临床表现、外周血象及治疗情况在各组各免疫分型(T-ALL、B-ALL与AML)间的差异。结果:小龄患儿较大龄患儿、ALL患儿较AML患儿肝、脾及淋巴结肿大发生率高。淋巴结肿大较肝、脾肿大发生率高。T-ALL、AML患儿WBC增高(>50×109/L)发生率较高。3～9岁的B-ALL患儿CR率最高。结论:无明显诱因单纯多个淋巴结肿大患儿需考虑AL的可能。T-ALL、AML患儿需警惕外周血WBC增高(>50×109/L)。3～9岁B-ALL患儿具有较好的治疗效果,T-ALL体现出了稍强的恶性趋势。AL患儿放弃治疗与死亡的比率仍然很高。

Objective：To retrospectively analyze the clinical data of childhood acute leukemia and dis cuss the treatment condition and morbidity characteristic of childhood acute leu kemia at different age levels and immunophenotypings. Methods：231 cases of patients received and cured firstly were divided into three groups named groupⅠ（before three years old）,groupⅡ（three to nine years old）,groupⅢ（nine to twelve years old）.SPSS17.0 was used to compare the differenc e of sex,clinical manifestation,peripheral blood cells and morbidity character istic of childhood acute leukemia at different groups and three kinds of immunop henotypings（T-ALL、B-ALL and AML）. Results：The incidence of liver,spleen and lymph node swelled at younger childhood pati ents and all childhood patients were higher than the older and AML one.The inc idence of lymph node swelled was higher than liver and spleen.The incidence of white blood cell rising to 50×109/L at T-ALL and AML childhood patien ts was higher.Complete remission rate of the B-ALL childhood patients who were three to nine years＇ old was the highest. Conclusion：Lymph node swelled with-out obvious incentive need us to think about AL.The incidence of WBC rising to 50×109/L at T-ALL and AML childhood patients sho uld be vigilant.The therapy effection of the B-ALL young patients between the tree and nine years old was the best among the three stages.The malignancy tend ency was embodied at T-ALL childhood patients.The rate of acute leukemia child ren giving up therapy and death was also high.