Klinische Padiatrie · 2009
Symptoms of childhood acute lymphoblastic leukemia: red flags to recognize leukemia in daily practice.
СтатьяНазвание и аннотация: Перевод в очереди
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Bernbeck B, Wüller D, Janssen G, Wessalowski R, Göbel U, Schneider D T
Аннотация
BACKGROUND: The aim of this study is to identify clinical "red flags" that may assist the general pediatrician in detecting patients with an acute lymphoblastic leukemia (ALL).
PATIENTS AND METHODS: Medical history and clinical findings of 189 children and adolescents, diagnosed with ALL between 1/1995 and 7/2004, were analyzed retrospectively.
RESULTS: Only 50% of patients presented with symptoms known in children with leukemia (fever, fatigue, paleness, hemorrhage); 5% were diagnosed accidentally in the absence of any clinical symptoms. The majority of patients had a medical history up to few weeks; in 11% of patients up to several months without impairing curability. 95% of the patients presented at diagnosis with enlargement of lymphnodes, liver and/or spleen. The characteristic laboratory constellation included mono-, respectively bi- or trilinear pathology of the blood count and with blasts in the blood smear.
CONCLUSION: The clinical diagnosis of ALL relies on physical examination and the blood count including microscopic examination. Therefore, the alertness of the treating paediatrician with regard to clinical findings and a pathologic blood count is more important than elaborate laboratory investigations. In uncertain cases, a close follow-up examination may help to unmask ALL, which will most likely be stratified in the low-risk-group.
PATIENTS AND METHODS: Medical history and clinical findings of 189 children and adolescents, diagnosed with ALL between 1/1995 and 7/2004, were analyzed retrospectively.
RESULTS: Only 50% of patients presented with symptoms known in children with leukemia (fever, fatigue, paleness, hemorrhage); 5% were diagnosed accidentally in the absence of any clinical symptoms. The majority of patients had a medical history up to few weeks; in 11% of patients up to several months without impairing curability. 95% of the patients presented at diagnosis with enlargement of lymphnodes, liver and/or spleen. The characteristic laboratory constellation included mono-, respectively bi- or trilinear pathology of the blood count and with blasts in the blood smear.
CONCLUSION: The clinical diagnosis of ALL relies on physical examination and the blood count including microscopic examination. Therefore, the alertness of the treating paediatrician with regard to clinical findings and a pathologic blood count is more important than elaborate laboratory investigations. In uncertain cases, a close follow-up examination may help to unmask ALL, which will most likely be stratified in the low-risk-group.
Предметные рубрики MeSH
AdolescentAntineoplastic AgentsBlast CrisisBone MarrowChildChild, PreschoolCore Binding Factor Alpha 2 SubunitDelayed DiagnosisDisease-Free SurvivalFemaleGene Expression Regulation, LeukemicGermanyHemoglobinometryHepatomegalyHumansImmunophenotypingIncidental FindingsInfantLeukocyte CountLymph NodesLymphatic DiseasesMaleOncogene Proteins, FusionPediatricsPhysical ExaminationPlatelet CountPrecursor Cell Lymphoblastic Leukemia-LymphomaRetrospective StudiesSplenomegalyETS Translocation Variant 6 Protein