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本文观察了28例小儿急性淋巴细胞性白血病（ALL）患儿细胞形态特征与诱导化疗反应性间的关系。原幼淋巴细胞特征的主要观察项目为胞浆空泡、核仁及凋亡细胞。根据临床分型（标危型和高危型）分别应用DOP或DOAP诱导化疗，上述方案无效者改用VP16、大剂量MTX等有效的药物。结果提示：21例空泡计分≥15，在治疗较短时间内（20．8天）获完全缓解（CR），而空泡计分＜15的7例诱导CR时间显著延长（59．8天）（R＜0．O1）；细胞核仁清楚≥25％的18例患儿获CR时间为19．5天，另10例核仁不清楚≥75％在治疗较长时间内获CR（60．6天）（P＜O．01）；另外凋亡细胞数≥20％的8例患儿诱导CR时间明显延长（57．3天），20例调亡细胞数＜20％诱导CR时间（24．1天）。我们认为上述形态特征的观察及计分对判断CR的难易有指导意义，可供临床选择合适的治疗，减少并发症，提高治疗成功率。
In this paper, 28 cases of children with acute lymphoblastic leukemia (ALL) cell morphology and induction of response to chemotherapy. The main observation items of the characteristics of immature lymphocytes were cytoplasmic vacuoles, nucleoli and apoptotic cells. According to the clinical classification (standard and high-risk type) were applied DOP or DOAP induction chemotherapy, the program ineffective switch to VP16, high-dose MTX and other effective drugs. The results showed that: 21 cases of voids score ≥15, in the treatment of a short period of time (20.8 days) was complete remission (CR), and voids score <15 of 7 cases of CR significantly prolonged (59.8 Day) (R <0.O1); 18 patients with clear nucleolus≥25% had CR time of 19.5 days, and the other 10 patients with no clear nucleolus≥75% had CR (60 .6 days) (P <0.01). In addition, 8 cases with more than 20% apoptotic cells had significantly longer CR (57.3 days) and 20 cases with less than 20% apoptotic cells 24.1 days). We believe that the observation and scoring of the above morphological features are of guiding significance for the determination of the difficulty of CR, which can be used to select the appropriate clinical treatment, reduce complications and improve the success rate of treatment.