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儿童慢性髓系白血病的定义、流行病学、病理生理学及诊断基本标准

Definition, Epidemiology, Pathophysiology, and Essential Criteria for Diagnosis of Pediatric Chronic Myeloid Leukemia.

作者信息

Suttorp Meinolf, Millot Frédéric, Sembill Stephanie, Deutsch Hélène, Metzler Markus

机构信息

Pediatric Hemato-Oncology, Medical Faculty, Technical University Dresden, D-01307 Dresden, Germany.

Inserm CIC 1402, University Hospital Poitiers, F-86000 Poitiers, France.

出版信息

Cancers (Basel). 2021 Feb 14;13(4):798. doi: 10.3390/cancers13040798.

Abstract

Depending on the analytical tool applied, the hallmarks of chronic myeloid leukemia (CML) are the Philadelphia Chromosome and the resulting mRNA fusion transcript BCR-ABL1. With an incidence of 1 per 1 million of children this malignancy is very rare in the first 20 years of life. This article aims to; (i) define the disease based on the WHO nomenclature, the appropriate ICD 11 code and to unify the terminology, (ii) delineate features of epidemiology, etiology, and pathophysiology that are shared, but also differing between adult and pediatric patients with CML, (iii) give a short summary on the diseases to be considered as a differential diagnosis of pediatric CML, (iv) to describe the morphological, histopathological and immunophenotypical findings of CML in pediatric patients, (v) illustrate rare but classical complications resulting from rheological problems observed at diagnosis, (vi) list essential and desirable diagnostic criteria, which hopefully in the future will help to unify the attempts when approaching this rare pediatric malignancy.

摘要

根据所应用的分析工具,慢性髓系白血病(CML)的特征是费城染色体以及由此产生的mRNA融合转录本BCR-ABL1。这种恶性肿瘤在儿童中的发病率为每100万人中有1例,在生命的前20年非常罕见。本文旨在:(i)根据世界卫生组织(WHO)的命名法定义该疾病,确定合适的国际疾病分类第11版(ICD 11)编码并统一术语;(ii)描述成人和儿童CML患者共有的以及不同的流行病学、病因学和病理生理学特征;(iii)简要总结需作为儿童CML鉴别诊断考虑的疾病;(iv)描述儿童CML患者的形态学、组织病理学和免疫表型结果;(v)说明诊断时观察到的血液流变学问题导致的罕见但典型的并发症;(vi)列出基本和理想的诊断标准,希望未来在处理这种罕见的儿童恶性肿瘤时有助于统一诊断方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/304d/7917817/c54bb384630f/cancers-13-00798-g001.jpg

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