Harousseau J L, Tobelem G, Schaison G, Chastang C, Auclerc M F, Weil M, Jacquillat C, Bernard J
Cancer. 1980 Nov 1;46(9):1996-2003. doi: 10.1002/1097-0142(19801101)46:9<1996::aid-cncr2820460917>3.0.co;2-r.
The cases of one hundred and forty-one patients (85 males, 56 females) treated for hyperleucocytic acute lymphocytic leukemia (H-ALL) were reviewed. In all cases the initial white blood cell count was over 100,000/cu mm. One hundred patients (71%) attained complete remission (CR). The median duration of CR was six months and the median survival was nine months for all patients and 11 months for those who attained CR. Age, initial hemoglobin, and the height of initial white blood cell count over 100,000 had no significant prognostic value. Relapses occurred earlier in patients with a mediastinal mass. The results depended on the treatment used. With modern treatment, including more intensive chemotherapy and central nervous system prophylaxis, CR rate increased from 65% to 81% and median duration of CR improved from four months to ten months. The most important prognostic difference was related to the sex: CR rate was higher (78.5% vs. 66%) and median duration of CR and hematological remission was longer for females (nine months vs. six months and ten months vs. 6.5 months, respectively). This difference only appeared with modern treatments, however: before 1972 the median duration of CR was four months for both sexes, and after 1972, it was eight months for males and 17 months for females. This difference could be explained by the site of the first relapse, which was testicular in only 2% of cases before 1972 and 27% (47% of the males who relapsed) after 1972.
对141例高白细胞急性淋巴细胞白血病（H-ALL）患者（85例男性，56例女性）的病例进行了回顾。所有病例的初始白细胞计数均超过100,000/立方毫米。100例患者（71%）达到完全缓解（CR）。所有患者CR的中位持续时间为6个月，中位生存期为9个月，达到CR的患者为11个月。年龄、初始血红蛋白以及超过100,000的初始白细胞计数高度均无显著预后价值。有纵隔肿块的患者复发较早。结果取决于所采用的治疗方法。采用现代治疗方法，包括更强化的化疗和中枢神经系统预防，CR率从65%提高到81%，CR的中位持续时间从4个月改善到10个月。最重要的预后差异与性别有关：女性的CR率更高（78.5%对66%），CR和血液学缓解的中位持续时间更长（分别为9个月对6个月和10个月对6.5个月）。然而，这种差异仅在现代治疗中出现：1972年以前，两性的CR中位持续时间均为4个月，1972年以后，男性为8个月，女性为17个月。这种差异可以通过首次复发的部位来解释，1972年以前只有2%的病例复发部位为睾丸，1972年以后为27%（复发男性的47%）。
