儿童高危急性淋巴细胞白血病重症感染后持久缓解临床分析

Clinical analysis of lasting remission of high⁃risk acute lymphoblastic leukemia in children after severe infection

目的探讨儿童高危急性淋巴细胞白血病重症感染后获得持久缓解的临床特点。方法回顾性分析郑州大学附属儿童医院2014、2015及2017年收治的3例高危急性淋巴细胞白血病重症感染后获得持久缓解的患儿资料,分析其临床及实验室特点,并复习相关文献。结果3例患儿临床分型均为高危急性淋巴细胞白血病,均有重症感染,治疗上均使用了多种抗感染药物及血液制品,均获得了持久缓解。结论儿童高危急性淋巴细胞白血病重症感染后获得持久缓解,可能与感染刺激炎症因子及细胞因子的产生激活了某些免疫通路相关,或是各种抗生素、血制品参与免疫调节,使机体重新具有了对肿瘤细胞的免疫监视功能。

Objective To investigate the clinical characteristics of children with high-risk acute lymphoblastic leukemia(ALL)receiving lasting remission after severe infection.Methods The data of 3 children with high-risk ALL who were treated in Children′s Hospital Affiliated of Zhengzhou University in 2014,2015 and 2017 were analyzed retrospectively.The clinical and laboratory characteristics of all patients were also analyzed,and the relevant literatures were reviewed.Results All 3 children were clinically classified as high-risk ALL with severe infection.A variety of anti-infective drugs and blood products were used in the treatment,and all achieved lasting remission.Conclusions Children with high-risk ALL after severe infection can acquire lasting remission,which may be related with the production of infection stimulating inflammatory factors and cytokines to activate certain immune pathways,or various kinds of antibiotics,blood products participating in the immune regulation to make the body regain the immune surveillance function of the tumor cells.