恶性实体瘤继发骨髓增生异常综合征急性髓系白血病11例分析  

Clinical analysis of myelodysplastic syndrome/acute myeloid leukemia secondary to malignant tumors in 11 cases

作　　者：李婵娟[1] 赵海丰[1] 赵伟鹏[1] 李倩[1] 赵智刚[1] 王晓芳[1] 于泳[1] 王亚非[1] 张翼鷟[1] 

机构地区：[1]天津医科大学肿瘤医院血液科,国家肿瘤临床医学研究中心,天津市肿瘤防治重点实验室,天津市300060

出　　处：《中国肿瘤临床》2015年第7期373-377,共5页Chinese Journal of Clinical Oncology

基　　金：国家自然科学基金面上项目(编号:30672208;81270603);天津市科委面上项目(编号:13JCYBJC22800)资助~~

摘　　要：目的:探讨恶性肿瘤继发骨髓增生异常综合征/急性髓系白血病(t-MDS/AML)的病因、临床特点及治疗策略。方法:对2008年1月至2014年7月在天津医科大学肿瘤医院就诊的11例t-MDS/AML患者的临床资料进行回顾性分析。结果:11例恶性肿瘤患者前期均有不同程度的细胞毒药物、抗代谢药物、含紫杉类药物(和)或放射线治疗史,与t-MDS/AML确诊中位间隔时间为36个月;患者主要表现为乏力、呼吸困难、发热、出血等血细胞减少相关症状;以对症支持治疗,免疫调节治疗及化疗为主,中位OS为28个月,中位DFS为19个月,3年总生存率44.4%。结论:t-MDS/AML继发于肿瘤性疾病或非肿瘤性疾病行细胞毒药物化疗或放疗后,总体疗效欠佳,预后不良;在制定放、化疗方案前,应充分考虑可能导致t-MDS/AML的危险因素,认真评估治疗受益及风险。Objective：To investigate the etiology, clinical characteristics, and treatment of myelodysplastic syndrome/acute myeloid leukemia （t-MDS/AML） secondary to malignant tumors. Methods： We retrospectively analyzed 11 patients with t-MDS/AML and investigated the treatment of primary tumors, clinical manifestations, treatment, and survival of t-MDS/AML patients. Results：A total of 11 patients were exposed to cytotoxic chemotherapeutic agents or radiation therapy for their primary tumors. The median latency was 36 months. Common symptoms were fatigue, dyspnea, bleeding, and infection, all of which were related to deficits in hematopoiesis. Therapeutic regimen included support therapy, immunomodulatory therapy, and chemotherapy. The median overall survival and disease-free survival periods were 28 months and 19 months, respectively, and the overall survival rate for 3 years was 44.4%. Conclusion：t-MDS/AML is a serious complication of chemotherapy or radiotherapy for a malignant or nonmalignant condition. The curative effect is limited, and prognosis is poor. Therefore, we should take t-MDS/AML into consideration when making treatment plans for cancer patients to evaluate treatment benefits and to avoid treatment-related complications.

关 键 词：骨髓增生异常综合征 急性髓系白血病 临床特征 病因 治疗 

分 类 号：R733.71[医药卫生—肿瘤]