赤白血病16例のfollow-up study

—その病態，病像転換および予後を中心として—

抄録

Sixteen cases of erythroleukemia, which were seen during past 10 years at Nagoya University Hospital and affiliated hospitals and were throughly followed up from their onset until death, were studied with emphasis on the alteration of clinical and hematological pictures in the entire course of the disease. Initial diagnosis was made in 15 cases at erythremic stage and in one at leukemic stage.
The mean survival time of these 16 cases from the time of their initial diagnosis was 9.5 months and its 50% survival time was 5.5 months. All patients at erythremic stage were treated by blood transfusion alone and did not receive any chemotherapy as a rule.
Thirteen out of 15 cases who were initially diagnosed at erythremic stage did develop frank acute leukemia as their terminal events. The mean term of the erythremic stage of 15 cases was 6.4 months, while that of the leukemic stage of 14 cases was 3.1 months. Among other findings, further enlargement of hepatosplenomegaly and reduction of platelet count were two major factors which preceded the leukemic transformation in erythroleukemia and could be used as a prognostic sign for the leukemic transformation of this disease.
Causes of death in 16 cases were as follows: infection in 6 cases, massive GI bleeding with paralytic ileus in 4, intracranial hemorrhage in 3, acute lung edema in 2, and cardiac tamponade in one. It is to be noted that massive GI bleeding and paralytic ileus due to leukemic infiltration in the intestine appeared at high rate as a terminal lifethreatening event.
In none of these 16 cases was there any substantial response to chemotherapy, although cytosine-arabinoside and daunomycin had a strong reducing effect of circulating and marrow leukemic cells.