Barcos M, Lane W, Gomez G A, Han T, Freeman A, Preisler H, Henderson E
Cancer. 1987 Aug 15;60(4):827-37. doi: 10.1002/1097-0142(19870815)60:4<827::aid-cncr2820600419>3.0.co;2-a.
Autopsy data on 1,206 children and adult patients with acute myelocytic leukemia (AML) (585), chronic granulocytic leukemia (CGL) (204), acute lymphocytic leukemia (ALL) (308), and chronic lymphocytic leukemia (CLL) (109) obtained from 1958 to 1982 were reviewed. This analysis has shown that, whereas the proportion of patients with residual AML at any anatomic site decreased significantly and uniformly over the entire study period, significant corresponding decreases in patients with CGL and ALL occurred only since 1976 and 1978, respectively. No significant corresponding decreases were noted in patients with CLL at any time. Significant decreases were also noted over time in the rates of extramedullary site involvement by AML, CGL, and ALL. Whereas the lymphoreticular organs, kidneys, adrenals, and pituitary were most often involved at autopsy by CLL, the testes, leptomeninges, dura mater, uterus, large bowel, and pancreas were most often involved by ALL. In general, patients with AML and CGL showed the lowest relative rates of involvement of the various organs by leukemia during the 24-year period. Whereas patients with AML and ALL showed significant decreases in the rates of involvement of nearly all anatomic sites during the most recent study periods, those with CGL and CLL showed corresponding decreases in only a few organ sites. The lower rates of organ involvement in patients with AML and ALL attest to the more aggressive eradication of leukemic cells by therapeutic regimens in these diseases over time. In particular, the significant decrease in the rate of meningeal involvement by ALL during the most recent period is probably attributable to central nervous system prophylaxis.
回顾了1958年至1982年期间获取的1206例儿童及成人急性髓细胞白血病（AML）（585例）、慢性粒细胞白血病（CGL）（204例）、急性淋巴细胞白血病（ALL）（308例）和慢性淋巴细胞白血病（CLL）（109例）患者的尸检数据。该分析表明，在整个研究期间，任何解剖部位残留AML患者的比例均显著且一致地下降，而CGL和ALL患者相应的显著下降分别始于1976年和1978年。CLL患者在任何时候均未出现相应的显著下降。AML、CGL和ALL髓外部位受累率也随时间显著下降。CLL尸检时最常累及的是淋巴网状器官、肾脏、肾上腺和垂体，而ALL最常累及的是睾丸、软脑膜、硬脑膜、子宫、大肠和胰腺。总体而言，在这24年期间，AML和CGL患者白血病累及各器官的相对率最低。在最近的研究期间，AML和ALL患者几乎所有解剖部位的受累率均显著下降，而CGL和CLL患者仅在少数器官部位出现相应下降。AML和ALL患者较低的器官受累率证明随着时间推移，这些疾病的治疗方案对白血病细胞的根除更积极。特别是，最近ALL脑膜受累率的显著下降可能归因于中枢神经系统预防措施。
