急性淋巴细胞白血病继发第二肿瘤3例

例 1,女 ,14岁。因面色苍黄半个月 ,发热 4ｄ就诊于青岛医学院附院。查体 :体温 3 8.6℃ ,精神差 ,中度贫血貌。皮肤可见瘀点、瘀斑 ,颌下、颈部及双腋下可触肿大淋巴结。血ＷＢＣ 3 4.0× 10 9/Ｌ ,原始 +幼稚淋巴细胞 0 .77,Ｈｂ 61ｇ/Ｌ ,ＰＬＴ 3 0× 10 9/Ｌ。骨髓像 :淋巴系恶性增生 ,原、幼淋 0 .97,苏丹黑Ｂ、过氧化酶染色均阴性。免疫分型 :ＣＤ354 2 .42 % ,ＣＤ10 5 7.2 3 % ,ＣＤ2 0 45 .6% ,ＣＤ3310 % ,ＣＤ1947.2 % ,Ｆ3( - ) ,诊断为急性淋巴细胞白血病 [ＡＬＬ(Ｌ2 Ｂ型 ) ]。按全国小儿血液学组制定的化疗方案治疗。患儿…     

粒细胞集落刺激因子治疗急性淋巴细胞白血病疗效观察

我们对急性淋巴细胞白血病 (ＡＬＬ)患儿在化疗基础上应用重组人粒细胞集落刺激因子 (ｒｈＧ ＣＳＦ) ,观察化疗后骨髓抑制时对血白细胞 (ＷＢＣ)和中性粒细胞绝对值 (ＡＮＣ)的影响 ,现报告如下。对象与方法一、对象　 1998～ 2 0 0 1年新乡医学院第一、二附属医院住院的ＡＬＬ患儿 5 2例 ,均为初治患儿 ,年龄 1～ 12岁 ,平均6 .2岁 ,均符合血液病诊断及疗效标准[1] 。二、化疗方案及分组　均采用ＶＤＰ(长春新碱、柔红霉素、泼尼松 )或ＣＯＤＰ +Ｌ(环磷酰胺、长春新碱、柔红霉素、泼尼松、天门冬酰胺酶 )方案。其中 30例应用ｒｈＧ ＣＳ…     

以急性淋巴细胞白血病首诊的儿童慢性粒细胞白血病临床特征分析

目的:分析慢性粒细胞白血病(chronic myeloid leukemia,CML)患儿初诊时即表现为急变期的临床特征。方法:以中国医学科学院血液病医院儿科收治的以急性淋巴细胞白血病(acute lymphocytic leukemia,ALL)为首诊的2例CML患儿为研究对象。收集患儿病史、体格检查资料及骨髓检查、...     

小儿急性淋巴细胞白血病和CD_(34)抗原表达

目的 　分析小儿急性淋巴细胞白血病 (ALL)CD3 4 表达特点及与Ph染色体表达、预后的关系。方法 　采用间接免疫荧光法分析 42例初治的ALL患者的免疫表型 ,其中B ALL 3 1例 ,T ALL 9例 ,N ALL 2例。结果　(1)小儿ALLCD3 4 阳性 14例 ,阳性率 3 3 3 %,其中 ,B ALL阳性 13例 (4 1 9%) ,T ALL阳性 1例 (11 1%) ,N ALL未检出阳性 ,B系ALL阳性率明显高于T系ALL(P <0 0 5 ) ,ALL L2 中的阳性率高于L1 (P<0 0 5 ) (2 )CD3 4 表达与外周血幼稚细胞有关 (P <0 0 1)与患者治疗前白细胞数、肝脾大及出血情况无关。 (3 )CD3 4 表达和脑膜白血病有关 (P <0 0 1)和缓解率无显著相关性。 (4 )Ph染色体阳性率为 3 1 2 %。CD3 4 表达和Ph染色体无显著相关性。 结论 　CD3 4 表达阳性组外周血原始细胞增多 ,引起脑膜白血病机会多。CD3 4 表达与ALL亚型、细胞分化程度有关。和治疗缓解率及染色体无显著关系。     

儿童急性淋巴细胞白血病并发糖尿病一例

患儿女,13岁。主因“发热头晕伴纳差,乏力皮肤瘀斑7d”于2002年6月7日入院。患儿无糖尿病家族史及既往糖尿病史。体检：贫血貌,肝大,浅表淋巴结轻度增大。血象示原 幼淋为8％;骨髓象示原 幼淋为86％;单抗示普通B淋巴细胞表型。故诊断为急性淋巴细胞白血病(简称急淋,ALL)。确诊后拟用长春新碱(VCR) 柔红霉素(DNR) 左旋门冬酰胺酶(L-ASP) 地塞米松(D EX),即VDLD EX方案诱导。化疗前空腹静脉血糖5．38mmol／L。     

15例小儿急性淋巴细胞白血病延误诊断的分析

在儿童急性淋巴细胞白血病发病前，存在着一种骨髓造血功能紊乱现象，数周或数月后发展为典型的急性淋巴细胞白血病。回顾我院，1990年1月至2003年12月所遇15例急性淋巴细胞白血病患儿延期诊断现象，现报告如下：     

15例急性淋巴细胞白血病患儿长期无病生存10年以上

我科自1986年元月～1995年12月较系统地收治小儿急性淋巴细胞白血病（ALL）107例[1],其中有15例长期无病生存达10年以上,现将15例临床资料分析讨论如下：     

急性淋巴细胞白血病前期11例

我们1989～2001年共诊治11例以一项或多项造血细胞减少为主要特征的病人,经诊断均为急性淋巴细胞白血病前期（pre-ALL）,现总结报告如下。     

儿童急性淋巴细胞白血病58例临床分析

目的　了解儿童急性淋巴细胞白血病(ALL)起病时的临床特点及与治疗的关系,方法　对儿童5 8例ALL起病时的临床症状,实验室检查进行回顾性分析。结果　本组5 8例经骨髓细胞学确诊的儿童ALL ,可发生于儿童时期每个年龄阶段,起病症状各不相同,白细胞计数最高达2 0 0×l09/L ,其中T -ALL 8例( 1 3 .8%) ,双表型4例( 6.9%) ,染色体异常1 9例。结论　儿童ALL起病时临床症状可以极不典型,其中B -ALL预后优于T -ALL ,而双表型则不易缓解,预后较差     

神经纤维瘤病伴急性淋巴细胞白血病1例

<正>患儿,男,5岁,因间断发热10 d,加重3 d入院。患儿入院10 d前无明显诱因出现发热,每日1次,热峰39℃,于当地诊所对症抗感染治疗,效果欠佳。入院3 d前发热增加为每日2~3次,查血常规示三系减低。患儿自发病以来,有乏力,偶有鼻衄,间断有膝关节疼痛。患儿生后4个月家长发现其右侧眼睑稍下垂,1岁时发现右脸较左脸增大,入院2个月余前于外院诊断为"神经纤维瘤病"(neurofibromatosis)。     

Ulcerating molluscum contagiosum in a boy with relapsed acute lymphoblastic leukemia

Molluscum contagiosum is an infectious disease presenting with flesh-colored, dome-shaped, umblicated papules. A few atypical presentations have been reported in immunodeficient patients. A 5-year-old boy with acute lymphoblastic leukemia, presented with bright white-colored papular lesions with no umblications on the chin during his continuation chemotherapy. Increased number of the lesions covered almost his entire chin in months. Topical therapies did not improve the lesions. After his bone marrow relapse, induction chemotherapy was withheld because of bronchopneumonia after febrile neutropenia. After initiation of a combination of systemic parenteral antibiotic and antifungal therapies, his parents squeezed one of his papular lesions. Meanwhile, systemic acyclovir was added to his therapy, because of herpes labialis. Despite the large spectrum of his therapies, in 1.5 months, this small lesion progressed to a large lesion with erythematous ground and a central ulceration. Etiology of the lesion could not be enlightened until a skin biopsy that was compatible with the molluscum contagiosum. A partial resolution was achieved by cryotherapy. In conclusion, molluscum contagiosum may present as an ulcerating lesion during childhood leukemia treatment. A skin biopsy should be performed for the accurate diagnosis of atypical cutaneous lesions in immunocompromised patients.     

急性淋巴细胞白血病化疗后出现B淋巴前体细胞增多1例

No abstract available

     

Ewing sarcoma as a second malignant neoplasm after acute lymphoblastic leukemia

Second malignant neoplasms (SMNs) are being increasingly recognized. This report describes a case of a 7-year-old girl with a history of acute lymphoblastic leukemia (ALL) who presented with a mass in her humerus that was diagnosed as Ewing sarcoma. Second malignant neoplasms are relatively rare in survivors of ALL treated without radiation. Even more unusual is the development of Ewing sarcoma as the SMN.     

Concomitant Ewing sarcoma and acute lymphoblastic leukemia in a 5-year-old girl

Malignancies from the Ewing family of tumors and acute lymphoblastic leukemia (ALL) are not known to be associated with each other. A 5-year-old girl was incidentally found to suffer from acute lymphoblastic leukemia during bone marrow staging for Ewing sarcoma of the radius. The simultaneous presence of two distinct neoplasms was confirmed by RT-PCR, with EWS/FLI1 type 1 rearrangement in the bone tumor and TEL/AML1 rearrangement in the marrow. She was treated with chemotherapy, radiotherapy, and surgery and was in remission of both diseases 31 months after diagnosis.     

Pediatric acute lymphoblastic leukemia complicated by secondary hemophagocytic lymphohistiocytosis

Hemophagocytic lymphohistiocytosis (HLH) may be familial or secondary to infections, malignancies, metabolic disorders. Infectious causes are mostly viral and EBV is the mostly frequently seen etiologic agent. In this case, we report a child with acute lymphoblastic leukemia (ALL), who had three episodes of secondary HLH, possibly due to two different viral etiologies, namely CMV and RSV together with her malignancy, during her induction‐consolidation treatment. Pediatr Blood Cancer 2009;53:491–492. © 2009 Wiley‐Liss, Inc.