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目的:观察浙江地区儿童白血病的生物学特征。方法:对2005年11月至2008年10月来浙江大学医学院附属儿童医院血液肿瘤科初诊的403例白血病病例资料进行回顾性分析,并采用前后比较法观察该地区儿童白血病发病的变迁情况。结果:403例患儿,年龄为15 d～17岁2个月,中位年龄为5岁1个月,男∶女=1.82∶1,其中ALL占68.73%(277例),AML占25.56%(103例),CML占4.96%(20例),AHL占0.74%(3例)。277例ALL患儿中B系∶T系=5.63∶1,TEL/AML1、BCR/ABL阳性率分别为14.29%(27/189)和5.07%(11/217)。103例AML患儿中M2最常见,AML1/ETO阳性率在AML和M2患儿中分别为25.40%(16/63)和50%(13/26),PML/RARa阳性率在M3患儿中为66.67%(10/15)。结论:本研究中ALL患儿男女发病率比稍高于西方国家;ALL患儿中TEL/AML1阳性率高于欧美等国;AML患儿及M2患儿中AML1/ETO阳性率高于英国、韩国等国。不同地区、不同种族间白血病患儿生物学特征的差异,可能提示我国东部地区儿童白血病患儿特有的遗传暴露及环境暴露因素。
Objective: To observe the biological characteristics of childhood leukemia in Zhejiang Province. Methods: From November 2005 to October 2008, 403 cases of leukemia newly diagnosed in the Department of Hematology and Oncology, Children’s Hospital Affiliated to Medical College of Zhejiang University were retrospectively analyzed. The changes of childhood leukemia in this area were observed by comparison before and after treatment. Results: A total of 403 children aged 15-17 years and 2 months with a median age of 5 years and 1 month were enrolled in this study. Male and female were 1.82:1, of whom ALL accounted for 68.73% (277 cases) and AML accounted for 25.56% (103 cases), CML accounted for 4.96% (20 cases) and AHL accounted for 0.74% (3 cases). The positive rates of TEL / AML1 and BCR / ABL were 27.2% (27/189) and 5.07% (11/217) respectively in 277 ALL children with B line: T line = 5.63:1. The positive rate of AML1 / ETO in 103 children with AML was 25.40% (16/63) and 50% (13/26) respectively in AML and M2 children. The positive rate of PML / RARa in children with M3 was 66.67% (10/15). The prevalence of TEL / AML1 in children with ALL was higher than that in Europe and the United States. The positive rate of AML1 / ETO in children with AML and M2 was higher than that in the United Kingdom, South Korea and other countries. Differences in biological characteristics of children with different ethnic groups and different ethnic leukemias may indicate specific genetic and environmental exposure factors in children with childhood leukemia in the eastern part of China.