论文部分内容阅读
急性早幼粒细胞白血病(APL)是急性粒细胞白血病(AML)的重要类型,常以并发出血和DIC、严重血小板减少和不典型的“颗粒过多型”早幼粒细胞为特征。1935年由Risak首先报导。1964年Didisheim等描述二例第V因子缺乏、低纤维蛋白原血症和血小板减少的病人。这些异常发现,在白血病缓解期消失而复发后又出现。Baker等报告一例APL用肝素治疗低纤维蛋白血症获得成功。迄今文献报导已超过214例。APL是AML中具有特殊临床表现和形态的类型。发病率:APL占整个白血病的3.6%或6~7%,约占AML总数的13%。男女比例相等。发病年龄在2~82岁之间。平均诊断年龄近四十岁。表现:很多病人有瘀点、紫瘢、鼻衄、牙龈出血、血尿、月经过多和胃肠道出血,可在诊断前2~8周出现。静脉穿刺部位常出血。出血倾向与肝病、感染和血小板减少无关。牙龈增生是很少有的,常无淋巴结病和脾肿大。皮肤浸润不常见,可能呈现红斑、
Acute promyelocytic leukemia (APL) is an important type of acute myeloid leukemia (AML), often characterized by hemorrhage and DIC, severe thrombocytopenia, and atypical “granulopoietic” promyelocytic cells. First reported by Risak in 1935. Didisheim et al 1964 described two patients with deficiency of factor V, hypofibrinogenemia and thrombocytopenia. These abnormalities found in the remission of leukemia disappear and recurrence appears again. Baker et al reported a case of APL with heparin treatment of low fibrinogen success. So far, more than 214 cases have been reported in the literature. APL is a type of AML with special clinical manifestations and morphologies. Incidence: APL accounts for 3.6% or 6-7% of all leukemias, accounting for about 13% of the total AML. The same is true for both men and women. Age of onset in the 2 to 82 years old. The average diagnosis of nearly 40 years old. Performance: Many patients have petechia, purple scar, epistaxis, bleeding gums, hematuria, menorrhagia and gastrointestinal bleeding, can be diagnosed 2 to 8 weeks before. Venous puncture site often bleeding. Bleeding tendency and liver disease, infection and thrombocytopenia has nothing to do. Gingival hyperplasia is rare, often without lymphadenopathy and splenomegaly. Skin infiltration is not common, may present erythema,