One Case Report Of Pediatric Acute Promyelocytic Leukemia

The patient, male, 8 years old, was admitted to the hospital because of skin petechia in October 2003. The relator related that the skin petechia and ecchymosis began gradually two days ago. Accompanied this the patient felt dizziness and weakness. Other symptoms such as hemoptysis, hematemesis, hematochezia, hematuria, fever and cough were not complained. General health good.PE: T 36.6 P 92per min R 20per min BP 95/65mmHg complexion is pale. Petechia and ecchymosis present on skin all over the body. Superfacial lymph nodes were impalpable. Posterior pharyngeal wall was not congested. Neck was supple, thyroid was normal and trachea was in the center position. Examination of lung and heart is regular. Abdomen was soft, no tenderness and rebound tenderness; Liver and spleen were impalpable. Neurological examination had no positive sign.Blood routine: RBC 2.8 X 1012/L, HB 72G/L , WBC 1.6X 109/L, Myeloblast 1%, Promyelocyte 63%, Band granulocyte 1%, Segmented granulocyte 2% , L 13%, M 3% , PLT 13 X109/L.Coagulation function: PT 18s, TT21s, APTT 63s, FIB 1.4g/L FDP 20mg/L, 3P'stest (+), D dimmer 3.4mg/l. urine- routine: RBC ++. Bone marrow examination acute promyelocytic leukemia (ANLL-M3 or APL) . cytochemistry staining: POX (+), NSE ( + ), Reaction is not inhibited by NaF .Immunocytochemistry staining: CD33 ( + ), CD13 ( + ), CD34 (-), HLA-DR (-) .Chromosome examination: 46, XY, t (15; 17) .After related examination were taken, the patient received hemostatic therapy and anti-DIC therapy. He simultaneously received All-trans retinoic acid (ATRA) therapy. He achieved complete remission (CR) after 36 days. After CR the patient received DA chemotherapy and ATRA as maintenance treatment, seven months by far no relapse was determined.