18例毛细胞白血病的临床分析

目的:探讨毛细胞白血病(HCL)的临床特点。方法:回顾性分析18例HCL患者的临床资料。结果:18例患者中,男13例,女5例,中位年龄51.5岁。腹胀是最常见主诉。初诊时脾大17例,肝大5例,淋巴结肿大6例。白细胞数增高6例,减低7例,正常5例。TRAP阳性15例,阴性3例。网状纤维增多3例,板层复合体(RLC)14例中存在1例,细胞遗传学改变7例中存在2例。11例单用干扰素治疗,8例有效,3例无效中2例行脾切除仍有效。干扰素联合脾切除3例有效。结论:HCL患者肝脾淋巴结肿大易见,网状纤维增多不多见,RLC少见,部分有细胞遗传学异常,干扰素联合脾切除是治疗的有效方法。

Clinical analysis of 18 patients with hairy cell leukemia

Objective:To explore the clinical feature of hairy cell leukemia(HCL).Methods:The clinical data of 18 patients with HCL were respectively analyzed.Result:Of the 18 study patients,there were 13 males and 5 females.Median age was 51.5 years.The most common complaint was abdominal fullness.In the initial diagnosis,splenomegaly was found in 17 cases,while hepatomegaly in 5 and lymphadenopathy in 6.Excess of granulocyte was displayed in 6,while neutropenia in 7 and normal in 5.Acid phosphatase reaction resistant to tartrate(TRAP positive)was seen in 15 and negative in 3.Excess of reticulin-fibrosis revealed in 3 and ribosomal-lamellae complexes(RLC)existed in 1 among 14 examined cases,abnormal karyotype was found in 2 among 7 examined cases.Interferon alone was effective in 8/11 cases.In the remaining 3 non-responder,splenectomy was effective in 2 patients.Interferon combined with splenectomy was effective in 3.Conclusion:HCL is a disease with high frequency of splenomegaly,hepatomegaly and lymphadenopathy.Excess of reticulin-fibrosis is not common,and RLC rarely reveals.Abnormal karyotype an be detected sometimes.Interferon combined with splenectomy is an effective therapy for HCL.