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总结分析了16例继发骨髓纤维化(SMF)的小儿白血病,其中急性淋巴细胞性白血病(ALL)12例;8例外周血白细胞<3.0×10~9/L;肝肿大10例。肋下≥3cm(3～14cm);脾肿大10例,肋下≥2cm(2～11cm);5例骨髓涂片与切片增生度不相符(相差2～5个级别);4例骨髓涂片未达白血病诊断标准;早期用不同药物化疗后骨髓变化相差较大。提示:小儿白血病伴SMF以ALL多见;肝脾肿大明显而外周血白细胞少要注意伴SMF;早期化疗药物的选择对疗效关系密切;骨髓切片与涂片结合检查对白血病伴SMF的诊断及疗效评价有重要价值。
Sixteen cases of childhood leukemia with secondary myelofibrosis (SMF) were analyzed and analyzed. Among them, 12 cases were acute lymphoblastic leukemia (ALL), 8 cases were peripheral blood leukocytes (3.0 × 10 ~ 9 / L) and 10 cases were hepatomegaly. 3 cm (3 ~ 14 cm) under the ribs, 10 cases with splenomegaly and 2 cm ~ 11 cm under the ribs. The bone marrow smears in 5 cases did not coincide with the section hyperplasia (difference of 2 ~ 5 grades) Lesions have not reached the diagnostic criteria of leukemia; early different bone marrow changes after chemotherapy with a large difference. Prompt: Pediatric leukemia with SMF to ALL more common; hepatosplenomegaly significantly less peripheral blood leukocytes with attention to SMF; choice of early chemotherapy drugs are closely related to the curative effect; combination of bone marrow and smear examination of leukemia with SMF diagnosis and Efficacy evaluation has important value.