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目的 探讨全血细胞减少性急性白血病 (PAL)和高白细胞性急性白血病 (HAL)临床特点。方法 回顾性分析 183例原发急性白血病 (AL)的临床资料。结果 PAL 3 8例 ( 2 0 8% )、HAL 42例 ( 2 3 0 % )。 2 3 0 %的急性髓细胞白血病 (AML) (尤其 5 6 3 %的急性早幼粒细胞白血病 )和 16 9%的急性淋巴细胞白血病 (ALL)表现为PAL ,髓外浸润较轻 ,全血细胞减少明显 ;73 7%的病例可在外周血发现数量不等的白血病细胞 ,早期病死率无明显增加 ,近期和远期疗效与一般类型AL无差别。 2 3 8%的AML(尤其 5 1 2 %急性单核细胞白血病 )和 18 6%的ALL表现为HAL ,肿瘤负荷大 ,髓外浸润重 ,早期病死率高 ,不易获得完全缓解 ,预后恶劣。结论 全血细胞减少或高白细胞是AL患者常见血象表现。了解其特殊血象 ,有利于指导临床诊断、治疗和判断预后。
Objective To investigate the clinical characteristics of pancytopenia acute leukemia (PAL) and high leucocyte acute leukemia (HAL). Methods The clinical data of 183 patients with primary acute leukemia (AL) were retrospectively analyzed. Results PAL 38 cases (280%), HAL 42 cases (230%). 230% of acute myeloid leukemia (AML) (especially 53.6% of acute promyelocytic leukemia) and 16.9% of acute lymphoblastic leukemia (ALL) showed PAL, extramedullary infiltration was less, whole blood cells And the number of leukemic cells in the peripheral blood was not significantly increased. The number of early leukemia cells in 73 7% of the cases was not found in the peripheral blood. There was no difference in the short-term and long-term efficacy between the two groups. 23.8% of AML (especially 52.1% of acute monocytic leukemia) and 18.6% of ALL showed HAL. The tumor burden was large, the extramedullary infiltrate was heavy, the early mortality was high, the complete remission was difficult to obtain, and the prognosis was poor. Conclusions Pancytopenia or high white blood cells are common manifestations of blood in AL patients. Understanding its special blood is conducive to guiding clinical diagnosis, treatment and prognosis.