Leukostasis in Children and Adolescents with Chronic Myeloid Leukemia: Japanese Pediatric Leukemia/Lymphoma Study Group
Leukostasis in Children and Adolescents with Chronic Myeloid Leukemia: Japanese Pediatric Leukemia/Lymphoma Study Group
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DOI：
10.1002/pbc.25803
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发表时间：
2016-03-01
影响因子：
3.2
通讯作者：
Shimada, Hiroyuki
中科院分区：
文献类型：
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作者：
Kurosawa, Hidemitsu;Tanizawa, Akihiko;Shimada, Hiroyuki
背景慢性粒细胞白血病(CML)儿童和青少年的白细胞沉积细节尚不清楚。对日本儿童白血病/淋巴瘤研究组1996~2011年间收治的256例慢性粒细胞白血病患儿进行了回顾性研究，其中238例被纳入本研究。有白细胞淤积者左肋缘以下白细胞中位数和脾大小明显高于无白细胞淤积者(458.5×10(9)/L比151.8×10(9)/L(P<0.01)，13比5 cm(P<0.01))。眼部症状14例，异常勃起4例，呼吸困难、晕厥、头痛、膝痛、听力障碍、股骨头无菌性坏死各1例。1例同时出现两种白血球淤积症状。在伊马替尼可用之前，有三例患者被诊断出来。5例患者接受了特殊治疗，其余15例患者经伊马替尼治疗后症状全部缓解。结论本次回顾性研究是迄今报道的最大的儿童和青少年慢性粒细胞白血病淤积症系列。我们的数据提供了有用的洞察在最近的儿童和青少年慢性粒细胞白血病病例中的白细胞淤积的特征。
BackgroundThe details of leukostasis in children and adolescents with chronic myeloid leukemia (CML) are unknown. This study determined the characteristics of leukostasis in children and adolescents with CML.ProcedureA total of 256 cases from a retrospective study of patients with CML conducted by the Japanese Pediatric Leukemia/Lymphoma Study Group from 1996 to 2011 were analyzed, and of these, 238 cases were evaluated in this study.ResultsLeukostasis was diagnosed in 23 patients (9.7%). The median leukocyte count and spleen size below the left costal margin in cases with leukostasis were significantly higher and larger when compared to those in cases without leukostasis (458.5 x 10(9)/l vs. 151.8 x 10(9)/l (P < 0.01), and 13 vs. 5 cm (P < 0.01), respectively). Leukostasis occurred with ocular symptoms in 14 cases, priapism in four cases, and dyspnea, syncope, headache, knee pain, difficulty hearing, and aseptic necrosis of the femoral head in one case each. One case had two leukostasis symptoms simultaneously. Three cases were diagnosed before imatinib became available. Five cases received special treatment, and in the remaining 15 cases, all of these symptoms resolved after treatment with imatinib.ConclusionsThis retrospective study represents the largest series of children and adolescents in which leukostasis of CML has been reported. Our data provide useful insight into the characteristics of leukostasis in recent cases of children and adolescents with CML.