演題詳細

ポスター / Poster

ポスター 51 (Poster 51) :小児血液 (Pediatric Blood)

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日程
2013年10月11日(金)
時間
16:50 - 17:50
会場
ポスター会場 / Poster (ロイトン札幌 3F エメラルドABCD)
座長・司会
遠藤 幹也 (Mikiya Endo):1
1:岩手医科大学 小児科学講座
 
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Clinical presentation and complication of children with hyperleukocytosis at onset of acute leukemia

演題番号 : PS-1-385

大島 淳二郎 (Junjiro Ohshima):1、杉山 未奈子 (Minako Sugiyama):1、寺下 友佳代 (Yukayo Terashita):1、佐藤 智信 (Tomonobu Sato):1、長 祐子 (Yuko Cho):1、井口 晶裕 (Akihiro Iguchi):1、有賀 正 (Tadashi Ariga):1

1:Pediatrics Dept., Hoakkaido Univ., Japan

 

Hyperleukocytosis in children with acute leukemia is associated with various complication and early morbidity due to the hyperviscosity, although the optimal management of childhood is unknown. Of ninety-six children with acute leukemia treated at Hokkaido University between June 2003 and March 2013, fifteen (15%) had an initial white leukocyte count (WBC) >50,000 / μl , and of which ten (10%) had WBC >100,000 /μl. The diagnosis of these patients were six B-precursor acute lymphoblastic leukemia (ALL), two T-lymphoblastic ALL and two acute monoblastic leukemia. Only a girl with T-ALL (WBC 924,000 /μl) was performed induction therapy together with continuous hemodiafiltration. An another boy with MLL positive AML (WBC 89,700 /μl) was complicated brain infarction and hemorrhage during induction therapy. We reviewed clinical data of these patients about age, gender, use of red blood cell or platelet transfusions, use of urate oxidase and/or allopurinol, presence or absence of extramedullary lesion and blood chemistry values; the peak levels of potassium, creatinine, urea nitrogen, uric acid and phosphorus during the first seven days. Between two groups with WBC >100,000 /μl and <100,000 /μl, it showed no significant difference in clinical presentation and blood chemistry values. Our experience suggest that serious event caused by hyperleukocytosis are rare in childhood, whereas cytoreduction during induction therapy may be considered for patients who had marked hyperleukocytosis at presentation or other risk factors of complications.

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