婴儿急性淋巴细胞白血病临床分析

Clinical analysis of infant acute lymphoblastic leukemia

目的总结我科10例婴儿急性淋巴细胞白血病(IALL)临床及实验室特点,探讨其治疗及预后的相关因素。方法回顾性分析2014年12月至2020年10月我院收治的10例IALL患儿的临床表现、实验室检查结果、治疗及预后情况。结果10例患儿中,2例为高危,8例为中危。在诱导治疗Ⅰ评估点时,有6例患儿微小残留病(MRD)<0.01%,缓解率为60.0%;在诱导治疗Ⅱ评估点时,4号患儿因化疗并发症死亡,剩余9例患儿MRD<0.01%,缓解率为90.0%;1号患儿于规律化疗1.5年后,在进行维持治疗时复发,放弃治疗后死亡;余8例患儿均存活至今,存活时间最长46个月,最短5个月。结论IALL为罕见病例,发病率低,因其特殊的生物学特征,预后差。本研究中1号患儿缓解后复发,4号患儿因化疗并发症死亡,8例存活至今。

Objective To summarize the clinical and laboratory characteristics of 10 cases of infantile acute lymphoblastic leukemia(IALL)in our department,and to explore the related factors of treatment and prognosis.Methods The clinical manifestations,laboratory examination results,treatment and prognosis of 10 IALL children admitted in our hospital from December 2014 to October 2020 were retrospectively analyzed.Results Among the 10 children,2 children were diagnosed with high risk and 8 cases were medium risk.At the evaluation point of induction therapyⅠ,there were 6 children with minimal residual disease(MRD)<0.01%and remission rate was 60.0%;at the evaluation point of induction therapyⅡ,No.4 child died due to chemotherapy complications,the MRD of the remaining 9 children was less than 0.01%,and the remission rate was 90.0%.After 1.5 years of regular chemotherapy,No.1 child recurred during maintenance therapy and died after giving up treatment.All the remaining 8 children have survived to date,with the longest survival time of 46 months and the shortest survival time of 5 months.Conclusion IALL is a rare case with low incidence rate.Because of its special biological characteristics,its prognosis is poor.In this study,No.1 child relapsed after remission,No.4 child died due to chemotherapy complications,and 8 cases have survived to date.