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目的探讨以骨髓坏死为首发表现的急性白血病(acute leukemia,AL)患者的临床特征与预后。方法回顾性分析15例以骨髓坏死为首发表现的AL患者的临床资料。结果 15例患者主要临床表现为发热、骨痛、贫血、血小板减少等,骨髓检查均可见典型的骨髓造血组织及基质组织坏死;起病至确诊骨髓坏死的中位时间为12d,发现骨髓坏死至确诊AL的中位时间为43d,其中2例诊断骨髓坏死至AL确诊时间2个月以上;治疗后,10例达持续完全缓解,未再出现骨髓坏死;15例随访1~14个月,1a总生存率为64.6%。结论对骨髓坏死患者应高度警惕AL,AL诊治是否及时、有效是影响患者预后的重要因素。
Objective To investigate the clinical features and prognosis of patients with acute leukemia (AL) presenting with bone marrow necrosis. Methods A retrospective analysis of 15 cases of bone marrow necrosis as the first manifestation of AL patients clinical data. Results The main clinical manifestations of 15 patients were fever, bone pain, anemia, thrombocytopenia and so on. Bone marrow examination showed typical bone marrow hematopoietic tissue and stromal tissue necrosis. The median time from onset to diagnosis of bone marrow necrosis was 12 days. The median time to diagnosis of AL was 43 days, of which 2 cases diagnosed bone marrow necrosis to AL diagnosis time of more than 2 months; after treatment, 10 cases continued to complete remission, no recurrence of bone marrow necrosis; 15 cases were followed up for 1 to 14 months, 1a The overall survival rate was 64.6%. Conclusion Patients with bone marrow necrosis should be highly vigilant AL and AL diagnosis and treatment is timely and effective is an important factor affecting the prognosis of patients.