The Clinical Characteristics Of The Children Who Suffered From Leukemia Combined Chickenpox

Objective:To investigate the epidemiology clinical manifestation, auxiliary examination, treatment and prognosis of children who suffered from leukemia accompanied with chicken-pox.Methods:The clinical data of the 45 leukemia combined with chickenpox children who admitted by Chongqing medical university children’s hospital from January 2008 and January 2016 were retrospective studied.Results:In the children who suffered from leukemia and varicella, male: female =2.2:1.0, average age were(5.9 ± 2.6 years); 4.4%(2 / 45) had the history of vaccination, 6.7%(3/45) without vaccination history, the other was unknown; 26.7%(12 / 45) had a clear history of exposure to Herpes zoster virus,and 28.8%(13 / 45) had no clear history of exposure, the other was unknown. 75.6%(34/45) were acute B lymphoblastic leukemia(B-ALL), 75.5%(34/45) of the children were in complete remission of the disease.80%(35/45) skin lesions were typical; 91.1%(41/45) had fever, 77.8%(35/45) was high fever, fever continued(6.3 ± 3.8) days; the average course was(11.7 ± 4.1) days.90.9%(40/45) WBC decreased, the average(1.6±0.9)×109/L; 64.4%(29/45) appeared PLT decrease, the average was(41.1 ±29.2)×109/L, which 26.7%(12/45) below 20×109/L; the Hb of 82.2%(37/45) children reduced, the average was(88.5 ±16.2g/L). 70.6%(24/34) CRP increased, the average was(40.2 ±31) mg/L.91.1%(41/45) of these children with complications and liver function damage was the majority(55.8%(24/43), followed by skin infection 46.7%(21/45), 40%(18/45)respiratory tract damage, 24.3%(9/37)myocardial damage,13.3%(6/45)abnormal coagulation function, 4.4%(2/45) sepsis; 37.7%(17/45) with multiple organ dysfunction.93.3%(42/45) were treated by antiviral drug; 93.3%(42/45) used IVIG, IVIG sooner or later was positively related with the length of the course in cure or improved group(r= 0.8, P= 0.000), 84.4%(38/45) were given anti infection treatment; 6.7%(3/45) received transfusion of fresh frozen plasma, mechanical ventilation treatment. 91.1%(41/45) cured or improved, 8.9%(4/45) dead.Through the statistical analysis of single factor analysis, sex, skin lesions, fever, high fever, WBC, Hb, PLT, CRP, liver injury, myocardial damage, skin infections, degree of danger and Classification of disease,had no difference in death group and cured or improved group(P > 0.05); age, pneumonia, visceral hemorrhage, multiple organ damage, disease stage were associated with death(P < 0.05), but through the logistic regression analysis found no death independent risk factors(P > 0.05).Conclusion:the Leukemia children with varicella,the highest infection rate was in complete remission,Compared with ordinary varicella children were more likely to have high fever, complication rate was obvious higher, easer complicated with liver function damage, respiratory tract injury, myocardial damage and so on. Early use of IVIG could shorten in course in the cure or improved children, elder, pneumonia, visceral hemorrhage, multiple organ damage, disease stage is the clinical risk factors of death.