Buchanan G R, Holtkamp C A
J Pediatr. 1985 Feb;106(2):239-42. doi: 10.1016/s0022-3476(85)80294-8.
We studied splenic function in children with cancer by quantitation of pitted, or pocked, erythrocytes (pocked RBC count), that is, the percentage of erythrocytes containing one or more membrane-bound vesicles, as determined by phase interference microscopy. The mean pocked RBC count in 93 normal children and adults was 0.49% (range 0% to 2.0%), with only 2.4% of normal subjects having values greater than 1.5%. Mean pocked RBC count in 28 children after splenectomy was 37% (range 3.2% to 81%). Among 181 children with cancer (525 specimens), the mean pocked RBC count was 1.06% (range 0% to 12.6%). Fifty-nine (32%) patients had one or more values greater than 1.5%, and 25 (13.8%) children had measurements greater than 3.0%, a level previously suggested to have clinical significance. Elevated pocked RBC counts (greater than 1.5%) occurred in more than one third of children with Wilms tumor and acute lymphoblastic leukemia, and in both patients with juvenile chronic myelogenous leukemia. Elevations in pocked RBC counts were not related to specific chemotherapy regimens or to disease activity. Mild splenic reticuloendothelial hypofunction occurs in many children with cancer and may contribute to the risk of infection in these patients.
我们通过对凹陷红细胞（即有凹痕的红细胞计数）进行定量研究了患癌儿童的脾脏功能，凹陷红细胞是指含有一个或多个膜结合囊泡的红细胞百分比，通过相干涉显微镜测定。93名正常儿童和成人的平均凹陷红细胞计数为0.49%（范围为0%至2.0%），只有2.4%的正常受试者的值大于1.5%。28名儿童脾切除术后的平均凹陷红细胞计数为37%（范围为3.2%至81%）。在181名患癌儿童（525份标本）中，平均凹陷红细胞计数为1.06%（范围为0%至12.6%）。59名（32%）患者有一个或多个值大于1.5%，25名（13.8%）儿童的测量值大于3.0%，这一水平之前被认为具有临床意义。超过三分之一的肾母细胞瘤和急性淋巴细胞白血病患儿以及青少年慢性粒细胞白血病患者的凹陷红细胞计数升高。凹陷红细胞计数升高与特定的化疗方案或疾病活动无关。许多患癌儿童存在轻度脾网状内皮系统功能减退，这可能会增加这些患者感染的风险。
