儿童急性髓系白血病临床研究

目的：了解儿童急性髓系白血病的临床特点、治疗疗效及预后因素。方法：对１９７８年８月～１９９５年１２月２７４例儿童急性髓系白血病进行临床总结和分析。结果和结论：中位确诊年龄７岁３个月，男∶女＝１．６３∶１，Ｍ２、Ｍ３型占８０％，高白细胞血症２０例，髓外白血病２４例，有Ａｕｅｒ小体者占３２．９％。治疗２４４例，分别以三种方案进行治疗，完全缓解（ＣＲ）率５５．８８％～９２．３１％，证明采用ＤＡ或ＤＡ＋Ｖｍ２６或Ｖｐ１６是提高ＣＲ的关键。影响诱导缓解因素为病初白细胞计数和肝脾肿大程度。通过ＳＰＳＳ统计学软件分析，ＡＭＬ亚型、Ａｕｅｒ小体、诱导缓解时间、髓外白血病等因素对远期预后有影响。

Clinical study of childhood acute myelogenous leukemia

OBJECTIVE: To investigate the clinical characteristics, treatment responsiveness and prognostic factors of childhood acute myelogenous leukemia. METHODS: Two hundred and seventy-four children with acute myelogenous leukemia diagnosed between 1978 and 1995 were retrospectively analyzed. RESULTS AND CONCLUSIONS: Male:female is 1.6:1. The median age was 7.25 years. M2 and M3 were the commonest subtypes(80%). Twenty cases were hyperleukocytosis and 24 with extramedullary involvement. Thirty two percent of the patients was Auer rods positive. Two hundred and forty-four patients received combination chemotherapy. Complete remission (CR) rates varied from 55.88% to 92.31%. Intensive chemotherapy(including DA, DA + Vm26 or Vp16) was the cornerstone for high CR rate. Other factors influencing CR rate were initial WBC count and hepatosplenomegaly.