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Clinical Observation of Acute Lymphocytic Leukemia with Mediastinal Mass.

Journal of the Korean Pediatric Society 1984;27(4):343-349.
Published online April 30, 1984.
Clinical Observation of Acute Lymphocytic Leukemia with Mediastinal Mass.
In Sil Lee, Hyo Seop Ahn, Chang Yee Hong
Department of Medicine, Seoul National University
종격동 종양을 동반한 급성 임파성 백혈병에 대한 임상적 관찰
이인실, 안효섭, 홍창의
서울대학교 의과대학 소아과학교실
Abstract
Twenty four cases of acute lymphocytic leukemia with mediastinal mass were studied at the Department of Pediatrics, Seoul National University Hospital from September 1965 to August 1983. Analysis were done with regard, to age, sex, chief complaints, organ size (liver, spleen and lymph nodes), initial hemoglobin, white blood cell and platelet count, initial bone marrow findings and lymphoblast surface markers. The response to therapy were evaluated by median duration of complete remission and survival. The results are as follows; 1)The ages of the patients ranged from 3 years and 8 months to 14 years and 9 months and median agas were 8 years and 1 month. The male to female ratio was 14 : 10 in 24 patients. 2) The most common chief complaints on admission were lymph node swelling, and then, bleeding tendency, pallor and dyspnea in decreasing frequency. The common physical findings on admission were hepatomegaly (100%), lymphadenopathy (91.7%) and splenomegaly (87.5%). 3)Hemoglobin ranged from 3.8~14.0 gm% with a median of 9.3 gm%. WBC counts ranged from 1,800 ~830,000 cells/mm3 with a median of 109,450/mm3 and 62.5% of cases showed initial WBC counts greater than 100,000/mm3. 4) Classification by lymphoblast surface markers in 9 cases showed 5 T-cell and 4 non-T, non-B cell leukemia. 5) The children with ALL with mediastinal mass were older in age at diagnosis and had higher median hemoglobin and WBC counts(p< 001) compared with those of the cases without mediastinal mass. 6) Patients with mediastinal mass responded poorly to treatment with a median duration of survival of 13 months as compared with 30 months for those without mediastinal masses (p<0.01). They also had more frequent early relapses with a median duration of first remission of 11 months.
Key Words: Acute lymphocytic leukemia, Mediastinal mass, Survival time


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