Kai T, Ishii E, Matsuzaki A, Okamura J, Ikuno Y, Tasaka E, Ueda K
Department of Pediatrics, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Leuk Lymphoma. 1996 Sep;23(1-2):119-23. doi: 10.3109/10428199609054810.
We studied 168 children with acute lymphoblastic leukemia (ALL) and 57 with acute nonlymphoblastic leukemia (ANLL) by retrospectively analyzing clinical symptoms, bone or joint involvement, and hematological findings to verify the clinical features and prognosis of children with acute leukemia who showed radiographic bone changes at the time of diagnosis. Of these, 36 with ALL (21.4%) and 6 with ANLL (10.5%) had symptoms referable to the bones or joints. Thirteen patients (7.7%) with ALL showed bone lesions radiographically. Phenotypically, 12 of the 13 had common ALL, 8 were incorrectly diagnosed and had received treatment for osteomyelitis or juvenile rheumatoid arthritis for 1 to 7 months prior to diagnosis of ALL. Leukocyte count was nearly normal with few or no blasts, and anemia and thrombocytopenia were mild or absent in all patients. Twelve of them remained in a complete remission for 26 to 148 months. Our data suggest that children with bone lesions related to acute leukemia exhibit clinical features that mimic infectious or collagen disease at diagnosis, and may belong to a subgroup of ALL with a better prognosis.
我们通过回顾性分析临床症状、骨骼或关节受累情况以及血液学检查结果，对168例急性淋巴细胞白血病（ALL）患儿和57例急性非淋巴细胞白血病（ANLL）患儿进行了研究，以验证诊断时出现影像学骨骼改变的急性白血病患儿的临床特征和预后。其中，36例ALL患儿（21.4%）和6例ANLL患儿（10.5%）有骨骼或关节相关症状。13例ALL患儿（7.7%）影像学显示有骨病变。从表型上看，13例中有12例为普通ALL，其中8例被误诊，在ALL诊断前已接受1至7个月的骨髓炎或幼年类风湿关节炎治疗。所有患者白细胞计数接近正常，原始细胞很少或无，贫血和血小板减少轻微或无。其中12例持续完全缓解26至148个月。我们的数据表明，与急性白血病相关的骨病变患儿在诊断时表现出类似感染性或胶原病的临床特征，可能属于预后较好的ALL亚组。
