论文部分内容阅读
慢性粒细胞性白血病在儿童期较少见，仅占儿童白血病的１～５％，且幼年型慢粒Ｐｈ染色体常为阴性，起病较急，临床贫血、出血、发热、感染等表现较成人明显，白细胞增高相对不明显，对治疗的反应差，病程短，预后差。本文总结１１例小儿慢粒，男８例，女３例，年龄５月～１２岁。就诊前病程２天～３年，多在１—２月。体格检查：贫血貌９例，出血点２例，肝大１例，脾大１例，肝脾大９例。实验室检查Ｈｂ６２～１２０ｇ／Ｌ，ＷＢＣ（１０．６～８２０．０）×１０９／Ｌ，中性粒细胞０．０４～０．８４，ＢＰＣ（２７～５８２）×１０９／Ｌ，骨髓检查：增生极度活跃８例，明显活跃３例，粒系０．５４５～０．９６５，红系０～０．４０５，巨核细胞１～９５个／片，ＮＡＰ检查８例，阳性率５～５８％，染色体检查４例，亚二倍体增多１例，８月后转为１５Ｐ＋，２１三体１例，Ｐｈ＋１例，正常１例。治疗４例，其余７例放弃治疗。小儿慢粒常易与其他白细胞增高性疾病混淆，在诊断中应加以鉴别。
Chronic granulocytic leukemia is rare in childhood, accounting for only 1 to 5% of childhood leukemia, and juvenile CK-negative Ph chromosome is often negative, onset of acute, clinical anemia, bleeding, fever, infection, etc. than adults Obviously, leukocytosis is relatively insignificant, poor response to treatment, short course, poor prognosis. This article summarizes 11 cases of children with CML, 8 males and 3 females, aged from May to 12 years old. Pre-treatment course of 2 days to 3 years, mostly in January-February. Physical examination: anemia in 9 cases, bleeding in 2 cases, 1 case of liver, splenomegaly, liver and spleen in 9 cases. Laboratory tests showed that Hb62 ~ 120g / L, WBC (10.6 ~ 820.0) × 109 / L, neutrophil 0.04 ~ 0.84, BPC 27 ~ 582 × 109 / Hyperplasia was extremely active in 8 cases, 3 cases were obviously active, 0.545 ~ 0.965 in granule, 0 ~ 0.405 in erythroid, 1 ~ 95 in megakaryocyte, 8 in NAP, the positive rate was 5 ~ 58% 4 cases of chromosome examination, sub-diploid increased in 1 case, after August 15P +, 21 trisomy in 1 case, Ph + 1 case, normal in 1 case. Treatment in 4 cases, the remaining 7 cases to give up treatment. Children with CML are often confused with other leukocytosis, and should be identified in the diagnosis.