高白细胞急性白血病44例分析

目的：探讨高白细胞急性白血病临床特征、早期并发症及其处理。方法：选择1990年至1996年我院住院治疗高白细胞急性白血病44例。结果：36例（81．6％）有髓外白血病表现。6例于确诊2周内死亡。19例（43．2％）获得完全缓解。中位生存期为4个月。较对照组有统计学差异。11例使用白细胞分离术患者5例出现白细胞反跳。口服羟基脲2～4g／d，白细胞24h内降低47．1％，同时给予水化治疗、碱化尿液和别嘌呤醇治疗，无肾功能损伤发生。结论：高白细胞急性白血病患者早期死亡率高，临床缓解率低，预后差。早期积极治疗可降低死亡率。

COMPLICATION AND OUTCOME IN ACUTE LEUKEMIA WITH HYPERLEUKOCYTOSIS

Objective: To discuss clinical characteristics, early complication and initial management ofhyperleukocytic acute leukemia (HLAL). Methods: 44 patients of HLAL enrolled in our hospital from 1990to 1996 were selected. Results: 36 cases (81. 8 % ) had extramedullary leukemia. Six patients died two weekslater. 19 cases (43. 2 % ) achieved complete remission, the median survival time of these patients was fourmonths. There was significant difference compared with the control group. 5 out of the 11 patients receivingeukophrersis developed rebound of leukocyte count. leukemia cells reduced 47. 1 % (32. 5 % ~ 75. 9 % ) 24hours with treatment of hydroxyures (2 ~ 4 g/d). All patients received vigorou hydration, alkalinization ofthe urine and allopurinol, and no patients developed renal dysfunction. Conclusion: HLAL has a highermorality, lower complete remission rate and poor outcome. Early appropriate management can reduce itsmortality.