Clinical Characteristics And Prognosis Of 27 Cases Of Childhood Central Nervous System Leukemia

Objective: To investigate the clinical manifestations,risk factors,efficacy and prognosis of childhood central nervous system leukemia(CNSL).Methods: T Clinical manifestations,diagnostic classification,characteristics of cerebrospinal fluid(CSF),treatment and survival of 27 childhood CNSL were retrospectively analyzed.Results: Of the 27 cases,20 cases were acute lymphoblastic leukemia(ALL)(15 B-ALL,5 T-ALL),and 7 cases owere acute myeloid leukemia(AML)(2 M2 a,2 M3 a,1 M3 b,1 M4,2 M5).7 cases were CNSL at the time of initial diagnosis,and 18 cases of CNS recurred after complete remission of bone marrow,2 of which were accompanied by bone marrow recurrence.The clinical manifestations are mainly facial paralysis,headache,muscle strength or paresthesia of the limbs,and disturbance of consciousness.The median survival time was 18(1-72)months.The initial diagnosis of CNSL,not reaching complete remission(CR)by 1 treatment course,peripheral blood leukocyte level(WBC)≥ 100 × 109 / L at initial diagnosis had relatively poor prognosis(P <0.05),of which CR1,Hyperleukocytosis at initial diagnosis were independent prognostic factor(P = 0.001 and P = 0.014).Conclusion: The clinical manifestations of childhood CNSL are diverse.One course of treatment has not reached complete remission.The peripheral blood leukocyte level at the time of initial diagnosis is a poor prognostic factor.Individualized stratification prevention can effectively reduce CNSL recurrence and improve prognosis.