以全血细胞减少为首发表现的急性白血病临床分析

目的：探讨以全血细胞减少为首发表现的急性白血病的临床特点。方法：回顾性分析111例急性白血病的临床资料。结果：以全血细胞减少为首发表现的急性白血病28例（25．2％），多见于急性髓细胞白血病（75％），尤其急性早幼粒细胞白血病。并发感染及出血症状比例较高，但髓外器官浸润较轻。外周血可见白血病细胞，骨髓象多表现为增生活跃，早期死亡率无明显增加。近期和远期疗效无差异。结论：全血细胞减少是急性白血病中常见的血象表现，并非预后不良标志，经标准方案化疗及加强支持治疗后疗效满意。

Clinical analysis of acute leukemia with pancytopenia as the first-onset manifestation

Objective:To study the clinical characteristics of acute leukemia with pancytopenia as the first-onset manifestation. Methods:The clinical date in 111 patients with acute leukemia were analyzed retrospectively. Results:Among 11 patients with acute leukemia,28 cases(25.2%) were acut leukemia with pancytopenia as the first-onset manifestion,which was common in the acute myeloid leukemia,especially acute progranulocyte leukemia. The proportions of complicated infection and hemorrhagic symptom were higher,but the leukemic cell infiltration in the extramedullary organs was relatively slight. The leukemic cells were still found in the peripheral blood,the bone marrow examinations always showed active hyperplasia. The death rate in early stage increased not so obvious,the difference between short-term and long-term effect was not significant. Conclusion:Pancytopenia is the common manifestation of hemogram in acute leukemia,but it is not a index of predicting the prognosis mala. Using the chemotherapy of standard scheme and strengthening the supportive therapy can achieve satisfactory results.