Dalle J H, Mortier L, Roumier C, Laï J L, Catteau B, Delaporte E, Nelken B
Clinique de pédiatrie, unité protégée A, Hôpital Jeanne-de-Flandre, CHRU de Lille, 59037 Lille, France.
Arch Pediatr. 2002 Oct;9(10):1046-9. doi: 10.1016/s0929-693x(02)00052-0.
Leukemia cutis (LC) are not rare in acute myeloid leukaemia (AML) in children but exceptionally reveal it. Most authors think that they have poor prognosis.
We report the case of an infant with isolated cutaneous involvement at the time of diagnosis of leukaemia. Bone marrow aspiration showed AML M5. The child was treated by LAME 91 protocol, arm "infant under one year of age". Complete remission, both in bone marrow and skin, was obtained after induction course. Then the patient received consolidation course and megatherapy followed by autologous bone marrow transplantation. Skin relapse occurred early. The complete remission no. 2 was not obtained by second line treatment: new LC appeared when PMN count increased more than 10(9)/l. Then, the child was treated with oral VP16 but disease progressed with more and more LC, followed by bone marrow relapse. Child's death occurred about one year after diagnosis.
皮肤白血病（LC）在儿童急性髓系白血病（AML）中并不罕见，但极少作为首发表现。大多数作者认为其预后较差。
我们报告一例在白血病诊断时仅有皮肤受累的婴儿病例。骨髓穿刺显示为AML M5。该患儿按照LAME 91方案“一岁以下婴儿组”进行治疗。诱导疗程后骨髓和皮肤均达到完全缓解。随后患者接受巩固疗程及大剂量化疗，接着进行自体骨髓移植。皮肤早期复发。二线治疗未获得第二次完全缓解：当中性粒细胞计数超过10⁹/L时出现新的皮肤白血病。然后，该患儿接受口服依托泊苷治疗，但疾病进展，皮肤白血病越来越多，随后出现骨髓复发。患儿在诊断后约一年死亡。
