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某些急性白血病患者在确诊后,并不需要立即治疗,这一认识是重要的。少数患者,尤其是老年人,可表现为“冒烟样”(smouldering)或“轮转样”(wheel spinning)急性白血病。这些患者在形态学上常诊断为急性非淋巴细胞性白血病(ANLL)而不是急淋(ALL)。患者可无症状或仅有贫血的症状和体征。血象中有中度血小板减少和/或粒细胞减少。很多患者骨髓诊断为ANLL,而白血病细胞仅占骨髓有核细胞的30%以下。在初次检查时常不能确定患者有肯定的白血病。经常要做血象检查以确定血液学异常为进行性或稳定不变的。“冒烟样”白血病患者在较长时间内可无进展。病情恶化而需治疗的依据是:血小板降至5万/mm~3,粒细胞下降至1000/mm~3,髓外白血病发
It is important that some patients with acute leukemia do not require immediate treatment after diagnosis. A small number of patients, especially the elderly, can manifest as “smouldering” or “wheel spinning” acute leukemia. These patients are often morphologically diagnosed with acute non-lymphocytic leukemia (ANLL) rather than acute lymphoblastic (ALL). Patients may be asymptomatic or have only anemia symptoms and signs. Medium blood thrombocytopenia and / or neutropenia. Many patients with bone marrow diagnosis of ANLL, leukemia cells only accounted for 30% of bone marrow cells below. In the initial examination is often not sure that patients have a positive leukemia. Blood tests are often performed to confirm hematologic abnormalities are progressive or stable. “Smoke-like” leukemia patients in a long time without progress. The condition is deteriorated and needs to be treated as follows: platelets reduced to 50,000 / mm ~ 3, neutrophils down to 1000 / mm ~ 3, extramedullary leukemia