关键词: 结核, 血液肿瘤, 儿童

Abstract: Objective To explore the clinical characteristics，diagnosis，treatment and prognosis of pediatric tuberculosis (TB) with hematological malignancy. Methods A retrospective study was performed on 7 children diagnosed with tuberculosis and hematological malignancy（including 6 cases of acute lymphoblastic leukemia and 1 of pleural lymphoma, 5 were male and 2 were female； the median age was 8 years old ranging from 3 years to 11 years）at Shanghai Public Health Clinical Center from April 2010 to September 2014. The diagnosis，clinical features, treatment and prognosis were evaluated.  Results Of the 7 patients, 6 children had acute lymphoblastic leukemia, and 1 had pleural lymphoma. Two of all patients were diagnosed TB before hematological malignancy, 5 patients during acute lymphoblastic leukemia chemotherapy. Clinical manifestations included fever, night sweats and hepatosplenomegaly in all cases, cough in 6 cases, losing weight and loss of appetite in 5 cases, joint pain in 1 case, breathing difficulty and superficial lymphadenopathy in 2 cases. IGRA was positive only in 5 patients (5/7). Anti-tuberculosis combined with chemotherapy was applied to 5 cases, and 2 cases gived up treatments, including 1 case of acute lymphoblastic leukemia and 1 of pleural lymphoma. During follow-up，2 case who gived up treatment died, other 5 patients showed tuberculosis cured，and 3 of 5 patients completed leukemia treatment and achieved continuous complete remission(they were in CCR for 3 years, 18 months and 6 months, respectively), 1 of the 5 patients just completed maintenance treatment, and 1 patient was still in maintenance treatment for leukemia.  Conclusion Early diagnosis of children TB combined hematological malignancy remains a challenge for clinicians, and anti-tuberculosis combined with chemotherapy is required that this isn’t going to affect their prognosis.

Key words: Tuberculosis, Hematologic neoplasms, Child