白血病·淋巴瘤
白血病·淋巴瘤
백혈병·림파류
JOURNAL OF LEUKEMIA & LYMPHOMA
2013年
12期
736-738,741
,共4页
白血病,淋巴细胞,急性%儿童%完全缓解%幼稚淋巴细胞%复发
白血病,淋巴細胞,急性%兒童%完全緩解%幼稚淋巴細胞%複髮
백혈병,림파세포,급성%인동%완전완해%유치림파세포%복발
Leukemia,lymphoblastic,acute%Children%Complete remission%Prolymphocytes%Relapse
目的 探讨儿童急性淋巴细胞白血病(ALL)完全缓解(CR)后骨髓幼稚淋巴细胞比例升高(5％～15％)的临床意义及对预后的影响.方法 回顾性分析ALL CR后幼稚淋巴细胞增多患儿的临床资料,按骨髓幼稚淋巴细胞比例分为≤5％组(阴性对照组),＞5％且≤10％组,＞10％且≤15％组,分析各组ALL复发情况.结果 ALL患儿CR后治疗期间出现骨髓幼稚淋巴细胞比例增高占40.54％(30/74),其中骨髓幼稚淋巴细胞比例＞5％且≤10％时复发率为21.05 ％(4/19),与阴性对照组的复发率15.91％(7／44)比较差异无统计学意义(P=0.895);骨髓幼稚淋巴细胞比例＞10％且≤15％时复发率为54.54 ％(6／11),与阴性对照组比较差异有统计学意义(P=0.014).儿童T-ALL与B-ALL出现骨髓幼稚淋巴细胞比例升高所占比例差异无统计学意义(P=0.078).结论 儿童ALL CR后治疗阶段骨髓幼稚淋巴细胞轻度(＞5％且≤10％)升高可能是骨髓正常的B系淋巴细胞反应性增生的结果,预后相对良好;而骨髓幼稚淋巴细胞比例＞10％且≤15％时,这些幼稚细胞极可能是白血病细胞,提示预后不良.
目的 探討兒童急性淋巴細胞白血病(ALL)完全緩解(CR)後骨髓幼稚淋巴細胞比例升高(5％～15％)的臨床意義及對預後的影響.方法 迴顧性分析ALL CR後幼稚淋巴細胞增多患兒的臨床資料,按骨髓幼稚淋巴細胞比例分為≤5％組(陰性對照組),＞5％且≤10％組,＞10％且≤15％組,分析各組ALL複髮情況.結果 ALL患兒CR後治療期間齣現骨髓幼稚淋巴細胞比例增高佔40.54％(30/74),其中骨髓幼稚淋巴細胞比例＞5％且≤10％時複髮率為21.05 ％(4/19),與陰性對照組的複髮率15.91％(7／44)比較差異無統計學意義(P=0.895);骨髓幼稚淋巴細胞比例＞10％且≤15％時複髮率為54.54 ％(6／11),與陰性對照組比較差異有統計學意義(P=0.014).兒童T-ALL與B-ALL齣現骨髓幼稚淋巴細胞比例升高所佔比例差異無統計學意義(P=0.078).結論 兒童ALL CR後治療階段骨髓幼稚淋巴細胞輕度(＞5％且≤10％)升高可能是骨髓正常的B繫淋巴細胞反應性增生的結果,預後相對良好;而骨髓幼稚淋巴細胞比例＞10％且≤15％時,這些幼稚細胞極可能是白血病細胞,提示預後不良.
목적 탐토인동급성림파세포백혈병(ALL)완전완해(CR)후골수유치림파세포비례승고(5％～15％)적림상의의급대예후적영향.방법 회고성분석ALL CR후유치림파세포증다환인적림상자료,안골수유치림파세포비례분위≤5％조(음성대조조),＞5％차≤10％조,＞10％차≤15％조,분석각조ALL복발정황.결과 ALL환인CR후치료기간출현골수유치림파세포비례증고점40.54％(30/74),기중골수유치림파세포비례＞5％차≤10％시복발솔위21.05 ％(4/19),여음성대조조적복발솔15.91％(7／44)비교차이무통계학의의(P=0.895);골수유치림파세포비례＞10％차≤15％시복발솔위54.54 ％(6／11),여음성대조조비교차이유통계학의의(P=0.014).인동T-ALL여B-ALL출현골수유치림파세포비례승고소점비례차이무통계학의의(P=0.078).결론 인동ALL CR후치료계단골수유치림파세포경도(＞5％차≤10％)승고가능시골수정상적B계림파세포반응성증생적결과,예후상대량호;이골수유치림파세포비례＞10％차≤15％시,저사유치세포겁가능시백혈병세포,제시예후불량.
Objective To investigate the clinical significance of bone marrow prolymphocytes increasing range from 5 ％ to 15 ％ after complete remission (CR) in children with acute lymphoblastic leukemia provide a prognosis index.Methods The cases of the children with acute lymphoblastic leukemia were analyzed retrospectively.They were divided into three groups,namely A group (N ≤ 5 ％),B group (5 ％ ＜ N ≤ 10 ％),C group (10 ％ ＜ N ≤ 15 ％) according to the bone marrow lymphoblast percentage,and their relapse rates were analysed.Results After the CR,the appearance of bone marrow prolymphocytes slightly increased in children with acute lymphoblastic leukemia accounted for 40.54 ％ (30/74).When the bone marrow prolymphocytes increased to 5 ％＜ N≤ 10 ％,the difference of relapse rates [21.05 ％ (4/19)] had no statistically significant compared with the negative control group [15.91％ (7/44)] (P =0.895),when they increased to 10 ％ ＜ N ≤ 15 ％,the difference of relapse rates [54.54 ％ (6/11)] had statistically significant compared with the negative control group (P =0.014).The difference of incidence rates of this slightly increasing between children' s B-ALL and T-ALL had no statistically significant (P =0.078).Conclusions The bone marrow prolymphocytes increase slightly (5 ％ ＜ N ≤ 10 ％) after CR in children with acute lymphoblastic leukemia might be the normal bone marrow B-lineage lymphocytes' reactive hyperplasia and the prognosis is relatively well.When the bone marrow prolymphocytes increase to 10 ％ ＜ N≤ 15 ％,these prolymphocytes are most likely to be leukemia cells and indicate the possibility of relapse.
