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患者 男,12岁.因乏力伴发热,皮肤出血点,于1986年9月21日入院.体检:T37.9℃,BP17.3/13.1kPa(130/98mmHg),面色苍白,全身皮肤有大小不等出血点,咽红,球结膜充血,双侧腹股沟扪及2～3个黄豆大小活动性淋巴结,质中,无压痛,肝肋下2cm,剑下5cm,质中无压痛,胸骨柄中下段轻压痛.化验:Hb120g/L,WBC80.0×10~9/L,N0.10,小型原幼淋0.82,BPC60×10~9/L,肝肾功能及脑脊液正常,骨髓增生极度活跃,粒系0.05,红系0.08,小型原淋0.40,幼淋0.42,POX(一),巨核细胞轻度增加,成熟障碍,报告为L_1.X线示右肺门淋巴结肿大.治疗经过:确诊为L_1后用VCP方案治疗4周,骨髓血象均完全缓解(CR),诱导缓解第4周起每周鞘注MTX7.5mg,DXM4mg1次,连用4周改为8周1次,以防脑膜白血病,VCP方案8周后予维持治疗,由于肝功能受损及骨髓受抑改为VP方案.1987年1月,1988年10月及1989年2月三次并发脑膜白血病,脑脊液化验
The patient, male, aged 12, was admitted to hospital on September 21, 1986. He was admitted to hospital on September 21, 1986. Physical examination: T37.9 ℃, BP17.3 / 13.1kPa (130/98 mmHg), pale, full-size skin Ranging from bleeding point, throat, conjunctival hyperemia, bilateral inguinal palpable 2 to 3 soybean size active lymph nodes, quality, no tenderness, liver rib 2cm, sword 5cm, quality no tenderness, sternal handle The lower part of the mild tenderness.Experiment: Hb120g / L, WBC80.0 × 10 ~ 9 / L, N0.10, small primordial 0.82, BPC60 × 10 ~ 9 / L, liver and kidney function and normal cerebrospinal fluid, bone marrow hyperplasia is extremely active, Granulocyte 0.05, erythroid 0.08, small protractor 0.40, infant shower 0.42, POX (a), megakaryocyte increased mildly, maturation disorder, reported as L_1.X line showed right hilar lymph node enlargement. After treatment: diagnosed as L_1 After treatment with VCP for 4 weeks, the bone marrow blood was completely relieved (CR). The fourth week after induction of remission weekly intrathecal injection of MTX7.5mg, DXM4mg1 times, once every 4 weeks to 8 weeks to prevent leukemia, VCP Eight weeks after the program to maintain treatment, due to impaired liver function and bone marrow suppression was changed to VP regimen in January 1987, October 1988 and February 1989 three concurrent leukemia, cerebrospinal fluid test