目的　探讨以骨质改变和高钙血症为首发表现的儿童急性淋巴细胞白血病（ALL）的临床特点及诊治。方法 回顾分析1例以骨质改变和高钙血症为首发表现的儿童B细胞ALL的临床资料。结果　患儿，男性， 6岁5个月，以腹痛起 病，初期检查发现骨质改变及高钙血症，后确诊ALL。采用CCLG-ALL-2015方案化疗，同时加用伊马替尼口服，目前已获 得缓解。结论　高钙血症和骨质改变可以是B细胞ALL首发表现。

　Objective　To explore the clinical features, diagnosis and treatment of childhood acute lymphoblastic leukemia (ALL) with bone changes and hypercalcemia as the first manifestation. Method　The clinical data of childhood B-cell ALL with bone changes and hypercalcemia as the first manifestation were retrospectively analyzed. Results　A boy, aged 6 years and 5 months old, started with abdominal pain. Bone changes and hypercalcemia were found at the initial examination, and ALL was confirmed later. The child was received oral administration of imatinib in addition to CCLG-ALL-2015 chemotherapy, and has been in remission. Conclusion　Hypercalcemia and bone changes can be the first manifestation of B cell ALL