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Objective:To investigate the diagnosis and treatment of congenital leukemia and the main factors affecting its prognosis.Methods:Clinical data of children with congenital leukemia admitted to Zhengzhou Children′s Hospital from July 2007 to December 2017 were retrospectively collected.Their clinical characteristics, chemotherapy and factors affecting their long-term survival were analyzed.Results:A total of 23 cases of congenital leukemia were collected, who mostly complained of " increased white blood cells, skin nodules and skin hemorrhage" . Among them, 10 cases abandoned the treatment, who all died according to the follow-up results.Among the 13 treated cases, 7 cases were male, and 6 were female.One of the 13 cases was a twin.Eight cases were acute myeloid leukemia, and 5 cases were acute lymphoblastic leukemia.One case did not perform the fusion gene test. MLL gene was positive in 2 cases and negative in 10 cases.No other fusion genes were detected.Karyotype analysis showed that 1 case was 21-trisomy and 12 cases had a normal karyotype.All 13 patients received symptomatic and/or reduced chemotherapy.The median follow-up time was 4 years and 11 months.Six cases recovered and 7 cases died during the follow-up.One case was diagnosed with acute lymphoblastic leukemia on the 6 th day after the birth in another hospital.He was not treated timely and came to Zhengzhou Children′s Hospital with general contract blocks at the age of 32 days.After checking, he was diagnosed with center leukemia and testicular leukemia.He developed a severe infection in the lung and brain after strong chemotherapy, and died even after the remote consultation with Lurie Children′s Hospital of Chicago.The other 6 cases died of severe infection and multiple organ injuries after chemotherapy, and no one died of leukemia relapse. Conclusion:Reduction chemotherapy may be an important treatment to children with congenital leukemia.
RESUMO
Objective To explore the risk factors of children with cerebral palsy during pregnancy and neonatal period in Xinxiang area.Methods A retrospective analysis of the relevant research data of cerebral palsy children in Xinxiang area was performed.The research objects were children with cerebral palsy born from May 1,2005 to April 30,2010.At the same time,3 healthy children were selected as the control group to analyze the related risk factors causing cerebral palsy in children.Results The risk factors of children with cerebral palsy in Xinxiang city were as follows : maternal nutritional status, vaginal bleeding during pregnancy, pregnancy-induced hypertension syndrome, and abnormal production history were associated with cerebral palsy (x2 =2.313,13.296,5.034,7.434, all P ＜ 0.05)during the perinatal period;related factors during neonatal period were premature birth,severe asphyxia, severe jaundice, and intracranial infection(x2 =4.637,29.50,4.633,5.107, all P ＜ 0.05).Multivariate Logistic regression analysis showed the history of severe asphyxia (OR =2.340,95 ％ CI: 1.250-4.440), severe jaundice (OR =4.110, 95％ CI:2.430-6.740) ,premature birth(OR =2.570,95％ CI: 1.410-4.770) ,pregnancy-induced hypertension syndrome (OR =2.350,95 ％ CI:I.020-5.440), vaginal bleeding during pregnancy (OR =73.600,95 ％ C1:3.060-17.750) and abnormal production history(OR =5.710,95％ CI: 1.250-26.310) were independent risk factors causing children with cerebral palsy.Conclusions The history of severe asphyxia, severe jaundice, premature birth, pregnancy-induced hypertension syndrome, vaginal bleeding during pregnancy and congenital dysplasia are independent risk factors of children with cerebral palsy in Xinxiang area.It should be strengthened to screen and standardize the management of high-risk newborn infants with cerebral palsy, and do well management for perinatal high-risk pregnant women management.Early prevention can help to reduce the incidences of cerebral palsy in local area.