영아기 백혈병의 임상적 고찰

Abstract

1) Background: The incidence of acute leukemia in infancy seems to be rare, but there is many problems involved in its treatment because of the high probability of failure and severe toxicity induced by the treatment. 2) Methods: Twenty-two infants with acute lymphobtastic leukemia(ALL) (n=12), acute myeloblastic leukemia(ANLL) (n=7) and chronic myeloblastic leukemla(CML) (n=3) were analyzed on the basis of clinical and laboratory data. 3) Results: Morphologically, 6 of the 12 infants with ALL were FAB Ll, and all of infants with ANLL were M5. Markedly enlarged liver(>5cm) was seen in four infants with ALL(33%), three infants with ANLL(33%) and all infants with CML, respectively. Markedly enlarged spleen( >5cm) was seen in five infants with ALL(42%), 2 infants with ANLL(29%) and 2 infants with CML, respectively. Hyperleukocytosis (>50,000/mm3) was seen in 6 infants with ALL(50%), 4 infants with ANLL(57% ), and all of infants with CML, respectively. By immunologic surface marker analysis, 6 of 11 B-lineage ALL were CALLA-, early pre-BALL. There are some aberrant markers(biphenotypic nature). The remission induction rate were 58% (7/12) in ALL and 29%(2/7) in ANLL. Infant ALL with hyperleukocytosis have a poorer prognosis than those without(P< 0.05). 4) Conclusion: Many of infant ALLs arise in cells at the earliest stage of B cell commitment, and intensive multiagent chemotherapy is necessary for the treatment of infants with acute leukemia.