儿童中枢神经系统白血病22例临床分析

目的分析22例急性白血病合并中枢神经系统白血病(CNSL)患儿的住院资料,为CNSL诊治提供参考。方法分析22例儿童CNSL的临床特征、实验室检查及预后。结果在303例儿童急性白血病中发生CNSL 22例,发生率7.3%,其中急性淋巴细胞白血病(ALL)18例,急性混合型白血病(MPAL)1例,急性髓细胞白血病(AML)3例;在18例ALL中,B-ALL 11例,T-ALL 7例,T-ALL合并CNSL发生率(22.6%)高于B-ALL(5.6%);CNSL常见临床表现有头痛、呕吐、惊厥及瘫痪等;CNSL预后差,死亡率高。结论 CNSL是急性白血病复发的主要原因之一,根据危险度来预防和治疗CNSL是关键。

Clinical analysis of 22 cases of childhood central nervous system leukemia

Objective To analyze the clinical data of childhood central nervous system leukemia(CNSL) and provide references for treatment for CNSL.Methods The clinical feature,laboratory data and outcomes of 22 cases of childhood CNSL in department of pediatric hematology & oncology in the past five years were analyzed retrospectively.Results The prevalence of CNSL in children acute leukemia was 7.3 %.There were 7 cases of T-cell ALL,11 cases of B-cell ALL,1 case of MPAL and 3 cases of AML in 22 cases of CNSL.The prevalence of CNSL in T cell-ALL was higher(22.6 %) compared with that in B-cell ALL(5.6%).The common clinical symptoms included headache,vomiting,convulsion and cranial nerve palsies.The outcome of CNSL was poor and the death rate was high.Conclusions CNSL is one of the main causes s of leukemia relapse.Preventing and treating CNSL according to the risk are very important.