白血病病像の変貌に関する臨床統計的研究 第1編 急性白血病初期像の変貌について

On 237 cases of acute leukemia admitted to our clinic from 1953 to 1965, the main symptoms and hematological findings in the initial stage were statistically evaluated. The observation time was devided into 3 periods; I (1953～1957), II (1958～1961) and III (1962～1965). 1) Peripheral blood picture: Severe cases with hemoglobin below 40% (Sahli) were 57.0% during the Ist period and were 28.2% during the IIIrd period. On the other hand mild cases with hemoglobin above 70% were 9.2% during the Ist period and increased to 17.2% during the IIIrd period. Similar tendency was observed on red blood cell count (R. B. C.). Severe cases with R. B. C. below 2×10(6) were found in 66.2% during the Ist period and decreased to 31.0% during the IIIrd period. Mild cases with white blood cell count below 1×10(4) were found in 33.9% during the Ist period and increased to 40.7% in the IIIrd period. Mild cases with leukemic blasts below 10% showed an increase from 22.6% in the Ist period up to 34.9% in the IIIrd period. Mild cases with thrombocytes above 1×10(5) increased from 13.1% in the Ist period up to 17.6% in the IIIrd period. 2) Myelogram: Mild cases with leukemic blasts below 20% increased from 33.9% in the Ist period up to 38.0% in the IIIrd period. Severe cases with erythroblastic cells below 5% gradually decreased from 75.4% in the Ist period up to 64.9% in the IIIrd period. Mild cases in which we maintained erythroblastic cells above 15% increased from 8.8% inthe Ist period up to 22.1%in the IIIrd period. 3) Clinical symptoms: Mild cases without hemorrhagic diathesis increased from 29.2% in the Ist period up to 42.0% in the IIIrd period. While severe cases with remarkable hemorrhagic diathesis gradually decreased from 34.6% in the Ist period up to 19.6% in the IIIrd period. Cases with hepatomegaly of more than 2 finger breath showed a slight decrease from 27.4% in the Ist period up to 20.5% in the IIIrd period. No conclusive tendency was observed on splenomegaly. Cases without palpable lymphnodes were increased from 35.0% in the Ist period to 41.7% in the IIIrd period, while cases with remarkable lymphadenopathy decreased from 18.3% in the Ist period to 13.1% in the IIIrd period. Cases with high grade fever decreased from 29.0% in the Ist period up to 13.3% in the IIIrd period. From these results the author confirmed that relatively mild cases of acute leukemia on admission have gradually increased recently. In addition the tendency of decrease of monocytic leukemia and increase of acute lymphocytic leukemia was observed.