磁共振查脑静脉鼻血栓在治疗佩加斯巴尔加斯的过程中
Xiao Zhang1, Yang Fu1, Hongsheng Wang1
1Department of Hematology, National Children's Medical Center, Children's Hospital of Fudan University, Shanghai, People's Republic of China.
大脑静脉鼻血栓塞 (CVST) 是治疗白血病的儿童的严重风险. 磁共振静脉扫描 (MRV) 查显著增加CVST检测,大多数病例是无症状的,结果更好.
科学领域:
- 儿科血液学 儿科血液学
- 神经学 神经学
- 在瘤学瘤学.
背景情况:
- 大脑静脉鼻血栓 (CVST) 在儿科白血病患者中具有显著的风险,可能复杂化疗,并导致长期的神经问题.
- 关于儿科CVST的数据是有限的,特别是与像佩加斯帕加斯 (PEG-ASP) 这样的治疗相关的数据.
- 了解患有急性淋巴细胞白血病 (ALL) 和淋巴细胞淋巴瘤 (LBL) 的儿童的CVST对于优化治疗和患者结果至关重要.
研究的目的:
- 描述与ALL/LBL.儿童的PEG-ASP相关的儿科CVST.
- 评估磁共振静脉学 (MRV) 查在诱导缓解治疗后检测CVST的有效性.
- 在这个儿科群体中确定CVST的风险因素和临床特征.
主要方法:
- 对27名被诊断患有CVST和ALL/LBL的儿童进行了回顾性队列研究.
- 该研究比较了没有常规MRV查的8年期间与MRV查后诱导缓解的4年期间.
- 分析了患者人口统计,临床表现,诊断结果和治疗结果的数据.
主要成果:
- 实施MRV查导致CVST检测率显著增加 (8.4%对1.6%,p <0.01).
- 超过一半 (58%) 的CVST确诊病例无症状,这表明早期,无声诊断的可能性.
- CVST的危险因素包括男性性别,T细胞免疫亚型和较高的初始血小板数量. 无症状患者的预后更好,治疗时间更短,长期并发症更少.
结论:
- 在儿童白血病患者中,PEG-ASP与CVST的显著发病率有关.
- 诱导缓解后的常规MRV查在检测儿科CVST方面非常有效,包括无症状病例.
- 通过MRV查进行早期诊断对于改善结果和减少PEG-ASP治疗ALL/LBL儿童的长期并发症至关重要.
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