小儿急性白血病外周血NK细胞的变化

本文对２０例小儿急性白血病进行了外周血ＮＫ细胞活性的测定。男１３例、女７例，年龄４￣１３岁。其中急淋５例、急非淋１５例。结果表明：急性白血病患儿ＮＫ细胞活性明显下降，与对照组（正常健康儿男１２、女１５，年龄为５￣１３岁）相比有显著差异，Ｐ〈０．０５，并与文献报道相符。文中指出，在白血病的治疗过程中从其缓解、复发时ＮＫ细胞活性变化的检测，有益于对病情的了解、感染的存在等估评。例数偏少有待进一步阐明。     

急性白血病患儿外周血T淋巴细胞亚群和NK细胞水平测定及临床意义

为探讨急性白血病患儿外周血T淋巴细胞亚群和NK细胞水平及意义 ,采用流式细胞技术测定 90例急性白血病患儿外周血T淋巴细胞亚群和NK细胞水平。结果 ,急性白血病患儿外周血T淋巴细胞亚群中CD3+ 、CD4+ 、CD4+ CD8+ 均明显低于对照组水平 (P <0 0 1) ,CD8+ 高于对照组水平 (P <0 0 1) ,NK细胞 (CD1 6+ 56+ )明显低于对照组水平 (P <0 0 1) ,经治疗缓解者T淋巴细胞亚群和NK细胞达正常水平。结果表明 ,T淋巴细胞亚群和NK细胞可作为急性白血病辅助诊断指标 ,为临床治疗提供实验依据     

小儿急性淋巴细胞白血病中枢神经系统白血病诊治现状

中枢神经系统白血病(CNSL)的防治是小儿急性淋巴细胞白血病(ALL)治疗的一部分。诊断时高白细胞计数、T细胞型及分子遗传学为t(4;11)和Ph 是CNS复发的危险因素,脑脊液不同检查结果的预后价值有待明确。头颅放疗已不用于标危ALL患儿,头颅放疗的预防剂量已减为12Gy,鞘内及全身化疗对CNSL的治疗有重要作用。部分小儿CNS复发经挽救治疗可以长期存活,早期CNS复发的患儿应在第2次CR期进行异基因骨髓移植。     

紫癜性肾炎NK细胞活性的变化

本文用＾１２５ＩｕｄＲ全血法检测了２５例紫癜性肾炎的ＮＫ细胞活性，并以２１名健康同龄儿童做正常对照组。结果表明急性期患儿ＮＫ细胞活性明显低于对照组（Ｐ〈０．０１），恢复期与对照组无明显差异（Ｐ〉０．０５）。提示ＮＫ细胞活性异常可能在紫癜性肾炎发病机制中起重要作用。     

儿童急性淋巴细胞白血病化疗后免疫系统重建的研究

目的 观察急性淋巴细胞白血病(ALL)儿童在化疗结束后淋巴细胞亚群和免疫球蛋白的变化,了解化疗后免疫系统的恢复过程.方法 采用流式细胞仪分析76例ALL治疗后停药患儿的外周血淋巴细胞亚群,应用单向琼脂扩散法测定其中64例患儿血清IgA、IgG、IgM的浓度.结果 CD3 HLA-DR 细胞、CD4 CD45RO-CD45RA-细胞百分率在停药后0～12个月组高于对照组(P<0.05),CD3 CD4-CD8 、CD8 CD28-细胞百分率在停药后0～12个月、12～24个月、24～48个月组均高于对照组,CD3 CD8-CD4 、CD4 CD29-、CD4 D45RO-CD45RA 细胞的百分率、CD4/CD8比值、CD45RA/CD45RO比值在停药各个阶段与对照组相比明显降低(P<0.05).CD19 CD5 细胞的百分率在停药后0～12个月、12～24个月组高于对照组,IgG浓度停药0～12个月低于参考值(P<0.05).结论 化疗结束后,患儿的免疫系统恢复需要较长的时间.NK细胞在停药时即正常.B细胞在停药2年后已经基本恢复,T淋巴细胞的恢复最慢.     

小儿急性白血病脑脊液细胞离心检查

用细胞玻片离心法对７８例急性白血病患儿４１８次脑脊液标本进行了细胞学检查，阳性率分别为６０．３％和３７．８％。这是一种简单、快速、有效的方法，对儿童中枢神经系统白血病检查比传统的测压、白细胞计数、蛋白定量三项指标敏感、可靠，可用于中枢神经系统白血病的早期诊断、疗效观察。     

急性白血病细胞的遗传学改变及其临床意义

目的 探讨小儿急性白血病（ＡＬ）细胞的遗传学改变及其临床意义。方法 采用细胞遗传学技术对８７例小儿ＡＬ进行染色体检查和临床治疗观察。结果 ８７例ＡＬ细胞核型异常检出率为６２％（５４／８７）,结果异常与白血病类型有特殊的对应关系,核型正常组缓解率高于核型异常组（Ｐ〈０．０５）,核型正常,超二倍体及ｔ（１５;１７）易位者疗效较好,而伴ｔ（９;２２）、ｔ（４;１１）及ｔ（８;２１）易位者疗效较差;缓解期     

小儿急性白血病外周血白细胞介素Ⅱ活性的测定及临床意义

小儿急性白血病外周血白细胞介素Ⅱ活性的测定及临床意义郭承吉，王巍中国医科大学第一临床学院杨晓玲，周正任微生物教研组白细胞介素Ⅱ（ＩＬ－２）是免疫系统中重要的淋巴因子，在体内外具有许多免疫调节特性，在一些血液病的发生、发展及治疗中起一定作用。我们检测了...     

小儿急性白血病血清NO_2/NO_3和cGMP的变化

研究小儿性白血病血清NO_2／NO_3和cGMP的变化及其临床意义，为本文研究目的。应用镀铜镉还原法和放射免疫法检测患儿血清中NO的代谢产物NO_2／NO_3和cGMP含量。结果表明：小儿急性白血病急性期血清NO_2／NO_3和cGMP的含量明显高于正常对照组和完全缓解期组（P＜0．01）；急性淋巴细胞白血病与急性非淋巴细胞白血病相比无显著性差异（P＞0．05）。完全缓解期组与正常对照组相比，无显著性差异（P＞0．05）。结论：血清NO的检测可用于判断小儿急性白血的病情和监测化疗效果的指标之一，揭示了临床选用NO的细胞毒性作用可能为小儿急性白血病的治疗提供新的方法。     

NUTRITIONAL ASSESSMENT OF PERIPHERAL BLOOD STEM CELL TRANSPLANTATION IN CHILDREN

Peripheral blood stem cell transplantation (PBSCT) has many advantages for patients because hematopoiesis and general condition return to normal more rapidly than they do following bone marrow transplantation. Thus, the authors hypothesize that the nutritional condition of patients also returns to normal more rapidly after PBSCT. The duration of insufficient nutrition was investigated in children undergoing PBSCT. The subjects of this study were 8 patients with malignant diseases. The factors measured were body weight, body fat, cholesterol, albumin, pre-albumin, and retinol-binding protein. These parameters were measured a day before transplantation, and then once a week for 4 weeks after transplantation. All parameters were recovered until day 28 from the lowest level in transplantation. In this study, all parameters returned to normal comparatively early. PBSCT causes little damage to patients' nutrition.     

HbF与儿童急性白血病的预后

本文用抗硷血红蛋白法测定了３９例急性白血病患儿胎儿血红蛋白（ＨＢＦ）含量。结果示：２９例急性淋巴细胞白血病（Ａｌｌ）ＨｂＦ平均值为３．１５％，１０例急性非淋巴细胞白血病（ＡＮＬＬ）ＨｂＦ平均值为５．２１％，均有轻度增高，且经统计学处理，ＡＮＬＬ较ＡＬＬ为高，差异有显著性意义；相关分析示ＨｂＦ含量与缓解后初次复发的时间的负相关关系有显著意义；发病危险度的估计表明ＨｂＦ水平与急性白血病复发或死亡之间存在非常显著性关系。     

LYMPHOKINES POST AUTOLOGOUS PERIPHERAL BLOOD STEM CELL TRANSPLANTATION IN CHILDREN

Malignant ectomesenchymoma (MEM) is a rare soft tissue tumor believed to arise from a pluripotent migratory neural crest cell and composed of both a mesenchymal element and a neuroectodermal element. The authors report the case of an 11-month-old male who presented with a local abdominal MEM and systemic metastases into lungs, liver, bones, and bone marrow. This is the first reported case of an MEM with initial bone marrow dissemination. The tumor consisted of a neuroblastoma component and a mesenchymal component with sarcomatous features. Diagnosis and therapy were complicated by the histological heterogeneity of the tumor, which also influenced the clinical appearance and course in this case. A literature search revealed 15 other evaluated cases that arose in soft tissue and had adequate clinicopathologic data. Complete surgical resection was the mainstay of treatment, and chemotherapy also appeared to be important. In all reported patients ( n = 3) with initial metastases or bone marrow dissemination, as in this case, no cure could be achieved. In patients with disseminated MEM, new therapeutic approaches such as high-dose chemotherapy followed by stem cell rescue should be considered, similar to the current strategy in patients with stage IV neuroblastoma or soft tissue sarcoma.     

小儿急性白血病骨髓细胞糖皮质激素受体表达及其临床意义

本文应用放射配体结合法测定了３０例ＡＬＬ骨髓细胞ＧＣＲ为７８７３±３００２位点／细胞；１７例ＡＮＬＬ为６１１３±１６２２位点／细胞（Ｐ＜０．０５）。形态学分型Ｌ１型１７例，ＧＣＲ为７２６７±３１７８位点／细胞；Ｌ２型１３例，ＧＣＲ为７６５０±３３６２位点／细胞（Ｐ＞０．０５）。临床分型标危型ＡＬＬ１４例，ＧＣＲ为８９９８±１９６３位点／细胞；高危型９例为５８４７±３８８５位点／细胞（Ｐ＜０．０５）。对１８例ＡＬＬ经联合化疗完全缓解前后比较发现，ＧＣＲ分别为８１１５±３２５８位／细胞和４６６９±２１０６位点／细胞（Ｐ＜０．０１）。本实验同时测定了ＡＬＬ和ＡＮＬＬ患儿血浆皮质醇浓度，平均分别为１１２．２０±４１．１４ｎｇ／ｍｉ和１０４．６５±４３．４９ｎｇ／ｍｌ，相关系数分别为ｒ＝０．１５和０．１１，说明ＧＣＲ表达水平不受皮质醇含量的影响。     

TRANSPLANTED PERIPHERAL BLOOD STEM CELLS,MOBILIZED BY CHEMOTHERAPY ALONE,CAN INDUCE PERSISTENT HEMATOPOIESIS IN CHILDREN WITH ACUTE LEUKEMIA

Three patients with leukemia were transplanted with peripheral blood stem cells mobilized by in tensification or maintenance chemotherapy alone. They maintained persistent reconstituted hematopoiesis for at least 9 years. The experience provides evidence that long-term marrow repopulating cells can be mobilized into the blood to an adequate repopulating extent by chemotherapy alone.     

DISTRIBUTION OF ABO BLOOD GROUPS IN CHILDHOOD ACUTE LEUKEMIA

A patient developed agranulocytosis after Epstein-Barr infection. Bone marrow examination revealed normal myelopoiesis with reduced mature neutrophil polymorphonuclear cells. IgG-specific antineutrophil antibodies (anti-HNA-1a) were found in serum and on polymorphonuclear cells, suggesting that the agranulocytosis after infectious mononucleosis was caused by an autoimmune mechanism.     

BLOOD VOLUME OF CHILDREN WITH LEUKEMIA

ABSTRACT. Blood volume was measured using ¹²⁵iodinated human serum albumin in 27 children with acute lymphoblastic leukemia, and in 7 children with various types of leukemia. Total blood volume was normal in patients without marked enlargement of spleen and liver, and increased progressively as spleen and liver size increased. The hypervoiemia was entirely due to expansion of plasma volume. In the children with marked hepatosplenomegaly, only hematocrit (but not red cell mass) was below the normal range in most cases. Both hematocrit and red cell mass were subnormal in the majority of patients without considerably enlarged spleen and liver. Therefore, anemia in children with marked hepatosplenomegaly may be partly caused by hemodilution of red blood cells in expanded plasma volume.     

脐血输注在急性髓系白血病患儿化疗后骨髓抑制期中的作用

为探讨脐血 (cordblood ,CB)对急性髓系白血病 (ALL)强烈化疗后骨髓抑制期的辅助及支持治疗作用 ,用密闭式采血法采集CB ,一个胎盘所采集CB为 1个单位。对 42例AML患儿采用HAE/DAE方案化疗 ,其中治疗组在强烈化疗后 ,短期内多个CB连续输注 ,平均 4～ 5个单位CB。结果治疗组骨髓抑制期天数短于对照组 (P<0 .0 1 ) ,骨髓抑制程度治疗组较轻 ,治疗组血小板和中性粒细胞相对较高 (P <0 .0 1 ) ,并且治疗组感染和出血发生率低于对照组 (P <0 .0 1 )。另外 ,输注CB治疗组缓解率高于对照组 (P <0 .0 5 )。结果表明 ,CB输注对AML强化疗后的骨髓抑制有明显的恢复作用 ,可以减轻骨髓抑制程度 ,缩短骨髓抑制期 ,从而减少化疗后感染出血发生率 ,并有助于AML达到完全缓解 ,CB输注治疗白血病是一种有效的辅助及支持疗法 ,有其独特的临床应用价值