骨髓局灶性残余白血病

3例急性淋巴细胞性白血病患者获得完全缓解(CR)后,外周骨髓仍存在未被抑制的局限性活性骨髓灶,骨髓细胞学检查表明常规穿刺部位的骨髓均呈CR髓像,但在局限性活性骨髓灶含有超过5%的幼淋白血病细胞,确定为骨髓残余白血病病灶,这与通常所指弥散分布于全身的白血病细胞而言的残余白血病系两个不同的概念。这是迄今为止首次发现的局限性骨髓残余病灶。这将对探讨白血病缓解的标准,制订治疗方案及判定预后具有意义。

FOCAL RESIDUE LEUKEMIA OF BONE MARROW

Leukemic Patients who have gained clinical complete remi-ssion(CR)after chemotherapy usually showed significant depression of bonemarrow on general scintigraphs.Three CR cases of acute lymphoblastic leu-kemia are reported as an exception.It has been found that some undepre-ssed active bone marrow foci were present in the peripheral bone marrowcavity.These foci were verified by bone marrow puncture as focal residueleukemia due to the presence of more than 5% lymphoblastic cells in thefoci while the bone marrow at routine puncture sites showed no lympho-blastic cell at all.It is obvious that these foci are quite different fromthose defined by the previous concept on residue leakemia which is gene-ralized dissemination of leuk(?)m(?)oughout the body.It isbelieved that this is the first report on such(?)residue leukemia so far.The characteristics of focal(?)esidue(?)one marrow scintigraphsare 1.most of these foci are(?)pheral bone marrow ca-vity particularly near the epiphysis of the kne(?)joint,2.Its distributionis symmetrical,3.the level of(?)identical,4.most of thevictims are young in age.This finding seems to be valuable for creating standardization of CR,facilitating the decision making in the treatment of leukemia and improv-ing its prognosis.