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首页> 外文期刊>Pediatric blood & cancer >Predictors of Being Overweight or Obese in Survivors of Pediatric Acute Lymphoblastic Leukemia (ALL)
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Predictors of Being Overweight or Obese in Survivors of Pediatric Acute Lymphoblastic Leukemia (ALL)

机译：小儿急性淋巴细胞白血病（ALL）幸存者超重或肥胖的预测指标

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Background Despite several advances in the treatment of Epstein-Barr virus (EBV) in recent years, patients with Epstein-Barr virus-associated hemophagocytic lymphohistiocytosis (EBV-HLH) do not always show satisfactory outcomes. We here conducted a nationwide survey in Japan to identify prognostic factors of EBV-HLH in children with this disease in an effort to improve the management and the outcomes of these patients. Procedure Between January 2003 and June 2008, we enrolled 98 children younger than 18 years of age who were diagnosed with EBV-HLH. We then studied the clinical characteristics and laboratory findings at the time of diagnosis with the aim to identify prognostic factors for EBV-HLH. Results The mean age of onset of EBV-HLH was 3.9 +/- 2.8 years. Most of our patients presented with fever, hepatosplenomegaly, lymphadenopathy, and hemophagocytosis of bone marrow. Sixty-two percent of patients showed T cell clonality, and 97% had EBV infection in either T or natural killer cells. Most patients (60%) were treated with a multi-agent chemotherapeutic regimen, including corticosteroid, etoposide, and cyclosporine. After initial treatment, 90.3% of patients were in remission, and 7 patients (8.2%) experienced recurrence of EBV infection. Among several prognostic factors, patients with both hyperbilirubinemia (>1.8 mg/dl) and hyperferritinemia (>20,300 ng/ml) at the time of diagnosis had significantly poorer outcomes than those with low serum bilirubin and ferritin levels. Conclusions These findings suggest that the therapeutic strategy for children with EBV-HLH could be tailored according to the laboratory findings at diagnosis. Pediatr Blood Cancer 2014;61:1257-1262. (c) 2014 Wiley Periodicals, Inc.
机译：背景技术尽管近年来爱泼斯坦-巴尔病毒（EBV）的治疗取得了一些进展，但爱泼斯坦-巴尔病毒相关的噬血细胞淋巴组织细胞增生症（EBV-HLH）的患者并不总是显示令人满意的结果。我们在日本进行了一项全国性调查，以确定患有这种疾病的儿童的EBV-HLH的预后因素，以期改善这些患者的管理和结局。程序从2003年1月到2008年6月，我们招募了98名18岁以下的被诊断出EBV-HLH的儿童。然后，我们在诊断时研究了临床特征和实验室检查结果，旨在确定EBV-HLH的预后因素。结果EBV-HLH的平均发病年龄为3.9 +/- 2.8岁。我们的大多数患者出现发烧，肝脾肿大，淋巴结肿大和骨髓噬血细胞增多症。 62％的患者表现出T细胞克隆性，而97％的患者在T或自然杀伤细胞中感染了EBV。大多数患者（60％）接受了包括皮质类固醇，依托泊苷和环孢霉素在内的多药化疗方案的治疗。初始治疗后，90.3％的患者缓解，7例（8.2％）的EBV感染复发。在几个预后因素中，高胆红素血症（> 1.8 mg / dl）和高铁蛋白血症（> 20,300 ng / ml）的患者在诊断时的预后明显低于血清胆红素和铁蛋白水平低的患者。结论这些发现表明，EBV-HLH患儿的治疗策略可根据诊断时的实验室发现进行调整。小儿血液癌2014; 61：1257-1262。 （c）2014年威利期刊有限公司

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