Dead Reasons and Related Factors of 42 Cases with Acute Leukemia in Chinldren / 实用儿科临床杂志

ABSTRACT

Objective To explore the dead reasons and related factors of acute leakemia(AL)in children.Methods The clinical data of 42 dead cases of children with AL,who were admitted to Guangzhou Children's Hospital between Jan.1999 and Mar.2007 were reviewed.Nineteen cases were boys,23 cases were girls;the aging from 4 months to 12 years old and 5 months.Of 42 children,21 cases were acute lymphoblastic leukemia(ALL),18 cases were acute myeloid leukemia(AML),3 cases were unclassified AL.Results Ten out of 12 early-dead cases died of bleeding.Among 30 cases who received chemotherapy,4 cases died of bleeding,others of myelosuppression combined with infection,14 of whom died from sepsis,3 cases with fungal infection,1 case with virus infection,4 cases with unknown pathogens.Sixteen children relapsed among those who got remission,half of them relapsed within 1 year since diagnosed.Treatment-related mortality(TRM)was 90%(27 out of 30 cases).The main causes of TRM were infection and hemorrhage.Hyperleukocytosis and bleeding were 2 risk factors related to early death in new-diagnosed children.Conclusions More emphasizes should be put on bleeding tendency during early treatment in children with AL and treatment of infection complications during induction chemotherapy to reduce TRM.