van Wering E R, Kamps W A
Am J Pediatr Hematol Oncol. 1986 Fall;8(3):220-4. doi: 10.1097/00043426-198623000-00008.
At present, the majority of children with acute lymphoblastic leukemia can expect a favorable outcome. However, leukemia in infants (0-1 year) still runs a dismal course. The first year of life also has a unique pattern of hematopoietic activity. We investigated possible association between these two findings. We examined the characteristics of 51 infants with leukemia, diagnosed from 1975 to 1984; 48/51 had evaluable data. Infants had a high frequency (39.6%) of hyperleukocytosis (greater than 100 X 10(9)/liter), early central nervous system involvement (27.1%), and cutaneous infiltration (18.8%). The respective numbers in patients greater than or equal to 1 year were 13.9, 4.8, and 1.0%. Acute nonlymphocytic leukemia was diagnosed in 18/48 infants (37.5%) compared to 128/892 (14.3%) in older patients. Infants had only acute leukemia of French-American-British (FAB) class M5 (10/19) or acute leukemia with unclassifiable but monocytoid blasts (8/19). This study confirms the presence of poor prognostic features in infant leukemia. The almost exclusive occurrence of monoblastic or monocytoid acute leukemia parallels the high proliferation rate of monocytes in this age group and the leukemic cells may thus well reflect frozen stages of monocytic differentiation.
目前，大多数急性淋巴细胞白血病患儿有望获得良好预后。然而，婴儿（0 - 1岁）白血病的病程仍然很严峻。生命的第一年也有独特的造血活动模式。我们研究了这两个发现之间可能存在的关联。我们检查了1975年至1984年诊断出的51例白血病婴儿的特征；51例中有48例有可评估数据。婴儿高白细胞血症（大于100×10⁹/升）的发生率很高（39.6%），早期中枢神经系统受累（27.1%），皮肤浸润（18.8%）。1岁及以上患者的相应比例分别为13.9%、4.8%和1.0%。48例婴儿中有18例（37.5%）被诊断为急性非淋巴细胞白血病，而年龄较大患者中892例中有128例（14.3%）。婴儿仅患有法美英（FAB）分类的M5型急性白血病（19例中有10例）或具有无法分类但为单核细胞样原始细胞的急性白血病（19例中有8例）。这项研究证实了婴儿白血病存在不良预后特征。单核细胞性或单核细胞样急性白血病几乎唯一的出现与该年龄组单核细胞的高增殖率相似，白血病细胞可能很好地反映了单核细胞分化的停滞阶段。
