摘要
对1991年10月至1996年2月收治的74例小儿急性淋巴细胞性白血病（ALL）同时作骨髓（BM）涂片与切片（活检）检查，发现11例伴有继发骨髓纤维化（SMF）。其中5例BM涂片与切片增生度不相符，涂片增生度减低或极度减低，切片示增生活跃至极度活跃（相差2～5个级别）；4例BM涂片未达ALL诊断标准，原淋＋幼淋＜0．3（0．08～0．25），切片见大量幼稚细胞浸润；6例外周血白细胞＜3×109/L（1．3～2．79×109/L）。4例早期用VLP方案为主治疗，持续完全缓解时间为16～30个月，疗效良好。2例早期用VCP方案治疗，一直未能完全缓解。BM切片示脂肪组织增多（70％和75％），疗效差。结果表明：BM切片与涂片结合对小二ALL伴SMF的诊断有重要价值；小儿ALL伴SMF的发生率可能不低；其治疗的成功与否与化疗早期的选择关系密切。
Observed and summarized the difference between the bone marrow(BM) smears and BM biopsies of 11 children and their treatment results of ALL with SMF in 74 ALL(14. 88%). In 5 cases the BM proliferation degree in smears appeared low/extremely low. But in biopsies showed active to extremely active. In 4 cases the rate of the primitive lymphocytes in BM smears were＜0. 3(0. 08-0. 25). But in BM biopsies there were large amount of lymphocytoblasts. 4 cases were treated with VLP plan mainly and 2 with VCP plan at the initial stage of the chemical treatment (CT). The 4 with VLP get complete remission (CR) in 5-7 weeks,and their CCR time were 16-30 monthes. The 2 with VCP showed unsuccessful. Their BM biopsies showed extremely low proliferation and fat tissues were 70% in 5-9 weeks after CT. The results showed: Combining BM smears with BM biopsies to diagmose ALL with SMF in children is very useful; the morbidity of ALL with SMF in children may not be rare; the success of therapy in All with SMF is related to the CT drug selected at the initial stage of the treatment.
出处
《中国小儿血液》
1997年第6期246-247,共2页
China Child Blood
