淋巴性白血病

Results In those patients with marrow invasion , 4 cases in I phase（4.2%）,12 cases in II phase（12.6%）,36 cases in Ⅲ phase（37.9%）and 43 cases in Ⅳ phase(47.4%);small lymphocytic、diffuse cleaved cell、lymphoblastic lymphoma are main pathologic types;patients with mediastinal lymphadenectasis、splenomegaly and spleen violations are prone to catch bone marrow involvement;56 cases of anemia in patients with bone marrow involuement(58.9%), 42 patients with thrombocytopenia (44.2%),27 cases with leukopenia (28.4%),49 cases of patients leukocyte increased (51.6%),so,anemia is common;three were 30 cases with three items abnormal（31.6％）and 65 cases with one item abnormal at least (68.4%),the incidence of abnormal peripheral blood in leukocythemia patients were higher than that in patients with bone marrow infiltration,Particularly the patients with increased leukocyte or three items abnormalities were more common in leukemia; Abnormal cells in peripheral blood were observed in 66 cases (69.5%); chemotherapy efficiency reached 65.2% in the patients with bone marrow involuement,the median survival time was 11.5 months.

结果发生骨髓侵犯病例中I期4例（4.2%）， II期12例（12.6%），Ⅲ期36例（37.9%），Ⅳ期43例(47.4%)；病理类型以小淋巴细胞性，弥漫型裂细胞性（改为：弥漫性大B细胞型淋巴瘤）和淋巴母细胞性淋巴瘤多见；纵隔淋巴结肿大、脾脏肿大和脾受侵患者易发生骨髓侵犯；骨髓侵犯患者外周血中贫血56例(58.9%)，血小板减少42例(44.2%)，白细胞减少27例(28.4%)，白细胞增高49例(51.6%)，以贫血多见；三项均异常30例(31.6%)，至少一项不正常65例(68.4%)，淋巴瘤细胞白血病患者外周血象异常发生率高于骨髓浸润患者，尤其是白细胞增高或三项均异常者更常见于白血病；66例(69.5%)外周血分类中发现异常细胞；骨髓侵犯化疗有效率65.2%，中位生存期11.5个月。

Results In those patients with marrow invasion , 4 cases in I phase（4.2%）,12 cases in II phase（12.6%）,36 cases in Ⅲ phase（37.9%）and 43 cases in Ⅳ phase(47.4%);small lymphocytic、diffuse cleaved cell、lymphoblastic lymphoma are main pathologic types;patients with mediastinal lymphadenectasis、splenomegaly and spleen violations are prone to catch bone marrow involvement;56 cases of anemia in patients with bone marrow involuement(58.9%)恶性淋巴瘤症状, 42 patients with thrombocytopenia (44.2%),27 cases with leukopenia (28.4%),49 cases of patients leukocyte increased (51.6%),so,anemia is common;three were 30 cases with three items abnormal（31.6％）and 65 cases with one item abnormal at least (68.4%),the incidence of abnormal peripheral blood in leukocythemia patients were higher than that in patients with bone marrow infiltration,Particularly the patients with increased leukocyte or three items abnormalities were more common in leukemia; Abnormal cells in peripheral blood were observed in 66 cases (69.5%); chemotherapy efficiency reached 65.2% in the patients with bone marrow involuement,the median survival time was 11.5 months.

结果发生骨髓侵犯病例中I期4例（4.2%）， II期12例（12.6%），Ⅲ期36例（37.9%）恶性淋巴瘤分期，Ⅳ期43例(47.4%)；病理类型以小淋巴细胞性，弥漫型裂细胞性（改为：弥漫性大B细胞型淋巴瘤）和淋巴母细胞性淋巴瘤多见；纵隔淋巴结肿大、脾脏肿大和脾受侵患者易发生骨髓侵犯；骨髓侵犯患者外周血中贫血56例(58.9%)，血小板减少42例(44.2%)，白细胞减少27例(28.4%)，白细胞增高49例(51.6%)，以贫血多见；三项均异常30例(31.6%)，至少一项不正常65例(68.4%)，淋巴瘤细胞白血病患者外周血象异常发生率高于骨髓浸润患者，尤其是白细胞增高或三项均异常者更常见于白血病；66例(69.5%)外周血分类中发现异常细胞；骨髓侵犯化疗有效率65.2%，中位生存期11.5个月。

We describe an 11-year-old boy with ureteropelvic obstruction secondary to pancreatitis following chemotherapy for acute lymphoblastic leukemia.

此个案报告为一11岁男孩因急性淋巴性白血病经化疗并发急性胰脏炎，进而导致肾盂输尿管交接处阻塞。

Such lymphocytes are indicative of acute lymphocytic leukemia.

这样的淋巴细胞提示急性淋巴母细胞性白血病的存在。

Majority of acute leukemias in infant, either acute lymphoblastic leukemia or acute myeloblastic leukemia, posses a chromosomal translocation affecting the 11q23 chromosome region which specifically inoles the mixed-lineage leukemia gene.1-3 Most pediatric leukemias with MLL rearrangement clearly hae a remarkably short latency.1,4 MLL gene rearrangement is also associated with secondary leukemias of patients preiously treated with the topoisomerase II inhibitors.4 The latency of these secondary leukemias is similarly ery short.4 Of note, the concordance rate of leukemia with MLL rearrangement in infant monozygotic twins approximates to 100%,1,4 and identical breakpoint in the MLL gene was shared in these pairs of identical twin infants with concordant ALL.1,4 Moreoer, the unique and clonotypic MLL fusion gene was detectable in neonatal blood spots for Guthrie cards from non-twined indiiduals who subsequently deeloped ALL.1,4 These obserations indicate not only that MLL fusion is generated in utero but also that MLL fusion proteins could be capable of inducing leukemic transformation with few, if any, secondary mutations.2,3,4 Greaes et al speculate that an MLL fusion protein somehow promotes rapid transition to full-blown disease in patients ia ery rapid clonal expansion, genetic instability, or inhibition of DNA damage repair.4 In general, for clonal expansion of malignancies, tumor cells often hae acquired strategies that escape immune sureillance of the hosts.5,6 Immune escape mechanisms also contribute to the failure of graft-ersus-leukemia effect after allogeneic hematopoietic stem cell transplantation.7 Therefore, leukemia cells could acquire some immune escape mechanisms during leukemogenesis.

绪论 绝大多数的婴儿白血病，不管是急性淋巴性白血病或是急性骨髓性白血病，在染色体11q23部位有染色体易位的情况；这个部位的染色体易位牵连了混合谱系白血病基因。大多数具有MLL基因重排的儿童白血病潜伏期明显短很多。MLL基因重排也和经拓扑异构酶II抑制剂治疗后的继发性白血病有关。这些继发性白血病的潜伏期类似地都非常的短。很重要的是，单卵双胞胎婴儿同时患有或同时免于MLL基因重排阳性的白血病的一致性接近100%；并且同样患有ALL的同卵双胞胎的MLL基因的断裂点是一致的。而且，这种独特的克隆特异性的MLL融合基因能够从那些得ALL的非双生个体出生时的血斑标本中检测到。这些发现表明MLL融合基因产生在胎儿还在子宫的是后，而且MLL融合蛋白能过和其他的基因突变一起诱导白血病的产生。Greaes 等推测MLL融合蛋白在某种情况下同过快速克隆增殖，遗传的不稳定性或是DNA损伤修复的抑制促使疾病迅速地全面爆发。恶性肿瘤细胞的克隆增殖通常已经获得了逃避机体免疫监视的能力。免疫逃避机制也归因于异体外周血干细胞移植后移植物抗白血病作用的失效。所以，白血病细胞在白血病的产生过程中可能获得了某些免疫逃脱机制。

In part Ⅲ of this ariticle,The authors report some other neoplasms and precancerous changes, and they are adenoma of stomach, hemangiofibroma of ovary,carcinoma of Fallopian tube, osteo-petrosis,cholangiocarcinoma, polyps, leukoplakia,atypical hyperplasia, papillar...

这些肿瘤是鼻咽癌、副鼻窦癌、鼻腔癌、食管癌、卵巢癌，淋巴细胞性白血病、白色肉瘸、淋巴肉瘤，外阴癌、纤维肉瘤、原发性肝癌、小肠癌、结肠癌、乳腺癌，圆形细胞肉瘤、纤维瘤、脂肪瘤、马立克氏病、肾癌、畸胎瘤、膀胱乳头状瘤和口腔癌。

The marrow between the pink bone trabeculae seen here is nearly 100% cellular, and it consists of leukemic cells of acute lymphocytic leukemia that have virtually replaced or suppressed normal hematopoiesis .

如图可见粉红色的骨小梁之间的骨髓几乎100%是细胞，是由急性淋巴母细胞性白血病的白血病细胞构成，这些细胞实际上替代或抑制了正常的造血作用。

However, on 4th March 2009, her life took a fatal turn. She was diagnosed with Acute Lymphoblastic Leukemia, a life-threatening disease that will post a staggering SGD 400,000 medical bill to her middle-income family (Xiaoou's mother is unemployed. Her father is a normal worker with average income of SGD 400 per month).

就在这梦想愈发清晰的边缘，一切都在一纸急性淋巴性白血病确诊通知书前面，瞬间崩塌了。40万新币的医药费对于她工薪阶层的家庭来说，是个天文数字（她妈妈下岗多年，爸爸是月收入约2000元人民币的普通职工）。

I will endeavour to find you some assistance.

我尽力帮你找人帮忙。

At first I only know bruck is the idol of American younglings, afterwards I returned back to Taiwan ,even in Beijing last year ,I saw her poster everywhere, I was so surprised at her charm.

起初我只晓得布鲁克雷德丝是美国少男少女崇拜的偶像，后来回台湾，甚至去年在北京，居然也四处看见她的海报，才惊讶她的魅力之大。