目的　通过糖皮质激素早期诱导试验评估儿童急性淋巴细胞性白血病的预后。方法　诱导试验是根据初发病时外周血幼稚细胞计数及服用糖皮质激素 (GC) 7d后外周血中幼稚细胞的动态变化。此后 ,所有病例都接受同样强烈的化疗方案。结果　 6 0例患儿中对泼尼松诱导试验敏感 (PGR)者为 4 9例 ,占 81 7% ,其中高危患儿 6例 ,中危患儿 8例 ,低危患儿 35例。在 4 9例PGR患儿中 38例 (77 6 % )处于持续缓解状态 (CCR) ,中位缓解期为 2 2 5个月 ;复发 3例 ,占 6 1%。 6 0例患儿中对泼尼松诱导试验不敏感 (PPR)者为 11例 ,占 18 3%。在PPR 11例中 ,5例早期复发 ,占 4 5 5 % ;2例达CCR ,占 18 2 %。从治疗第 19天、第 30天的骨髓检查 ,PPR组 19dM1、M2 、M3分别为 72 7%、18 1%、9 2 % ;PGR组 19dM1、M2 分别为 96 %、4 % ,无一例为M3 。达CR时间 ,PPR组明显迟于PGR组。结论　GC在用于治疗恶性淋巴细胞增生性疾病中 ,起到了重要作用。 Objective To assess the prognosis of children with acute lymphoblastic leukemia by early induction of glucocorticoid. Methods Induction test is based on the initial onset of peripheral blood naive cells and 7d after taking glucocorticoid (GC) in peripheral blood of immature cells in the dynamic changes. Since then, all cases received the same strong chemotherapy. Results Of the 60 cases, 49 were prednisone-induced tests (PGRs), accounting for 81.7%. Among them, 6 were high-risk children, 8 were moderate-risk children, and 35 were low-risk children. Of the 49 patients with PGR, 38 (77.6%) were in sustained remission (CCR) with a median response time of 225 months; 3 were recurrent, accounting for 61%. Of the 60 patients who were insensitive to prednisone induction (PPR), 11 (18.3%) were reported. In the 11 cases of PPR, 5 cases had early recurrence, accounting for 45.5%; 2 cases reached CCR, accounting for 18.2%. According to the bone marrow examination on day 19 and day 30, the levels of 19dM1, M2 and M3 in PPR group were 72.7%, 18.1% and 92% respectively, while those in PGR group were 96% and 19% respectively M3. At CR time, PPR group was significantly later than PGR group. Conclusion GC plays an important role in the treatment of malignant lymphoproliferative diseases.