区分白血病反应与儿童血液性恶性瘤的因素
Heeyung Kim1, Tatsuki Ikuse2, Toshihiro Matsui2
1Center for Postgraduate Education and Training, National Center for Child Health and Development, Tokyo, Japan.
概括
儿童的白血病反应 (LR) 通常是由感染引起的,因此将其与血液恶性瘤 (HM) 区分开来至关重要. 诸如年龄,潜在的疾病和特定的实验室结果等因素可以帮助区分这些疾病.
科学领域:
- 儿科血液学 儿科血液学
- 在瘤学瘤学.
- 临床病理学 临床病理学
背景情况:
- 关于儿童白血病反应 (LR) 的原因和结果的信息有限.
- 在儿科患者中区分LR与血液性恶性瘤 (HM) 是具有挑战性的.
研究的目的:
- 确定将儿科白血病反应 (LR) 与血液性恶性瘤 (HM) 区分开来的因素.
- 为了调查儿童LR的病因和预后.
主要方法:
- 一个单中心的病例控制研究,涉及儿童患者 (<18岁) 的白细胞 (WBC) 计数≥50,000/μL.
- 使用后勤回归分析来确定LR与HM的预测因素.
主要成果:
- 感染约占LR病例的50%,其中细菌病和呼吸道感染最常见.
- 预测LR的预测因素包括年龄较小 (<2岁),潜在疾病的存在,特定的WBC和血小板计数以及乳酸脱酶 (LDH) 和C反应蛋白 (CRP) 水平.
- 虽然LR组的30天死亡率较高,但与HM组相比,这种差异在统计学上并不显著.
结论:
- 传染病是小儿白血病反应 (LR) 的主要原因.
- 对LR的预后可能比血液性恶性瘤 (HM) 更差.
- 临床因素,如年龄,潜在疾病和实验室标记 (WBC,血小板计数,LDH,CRP) 对于区分LR与HM有价值.
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