35例治疗相关血液肿瘤患者的临床特征及预后分析  

Clinical characteristics and prognosis of 35 patients with therapy-related hematological neoplasms

作　　者：卢绮思[1] 许娜[1] 周璇[1] 蔡耿喜 李琳[1] 李玉玲[1] 陆紫媛 黄继贤[1] 刘启发[1] 刘晓力[1] 

机构地区：[1]南方医科大学南方医院血液科,510515 [2]南方医科大学南方医院乳腺科 ,510515

出　　处：《中华血液学杂志》2016年第3期221-226,共6页Chinese Journal of Hematology

基　　金：国家自然科学基金（81170521）;南方医科大学南方医院院长基金（20122013）

摘　　要：目的探讨治疗相关血液肿瘤的临床特征及预后。方法采用细胞形态学、流式细胞术、间期荧光原位杂交技术（I-FISH）、染色体核型分析对35例治疗相关血液肿瘤患者进行诊断和分型并回顾性分析其临床特征及预后。结果35例患者中，治疗相关急性髓系白血病（t-AML ）20例，治疗相关急性淋巴细胞白血病（t-ALL ）4例，治疗相关急性混合细胞白血病1例，治疗相关非霍奇金淋巴瘤（t-NHL） 8例，治疗相关骨髓增生异常综合征（t-MDS ）2例。第一肿瘤至治疗相关恶性血液肿瘤的中位发病间隔期为29（16-90）个月，中位生存时间14（1-60）个月，3年累积生存率为17.1%。在25例治疗相关性急性白血病患者中，40.0%（10/25）合并复杂核型，36.0%（9/25）合并MLL断裂基因重排，12.0% （3/25）合并AML-ETO融合基因阳性，1例合并NPM1点突变，1例合并P16基因缺失。结论治疗相关血液肿瘤患者的预后差。ObjectiveTo investigate the morbidity, treatment outcomes and prognosis of 35 therapy-related hematological neoplasms patients.MethodsA total of 35 cases of therapy-related hematological neoplasms were examined genetically and immunologically using flow cytometry, karyotype analysis and FISH, and their clinical data were retrospective analyzed and literatures were reviewed.ResultsAmong 35 patients, there were 20 cases of therapy-related acute myeloid leukemia （t-AML）, 4 cases of therapy-related acute lymphoblastic leukemia （t-ALL）, 1 case of acute mixed leukemia, therapy-related non-hodgkin＇ s lymphoma （t-NHL） in 8 cases and myelodysplastic syndrome （t-MDS） in 2 cases. The median onset of t-HN was 29（16-90） months, the median OS of t-HN was 14（1-60） months, and 3 years of OS was 17.1%. Among therapy-related acute leukemia （t-AL） patients, 40% （10/25） patients had combined complex karyotype, 36% （9/25） patients with MLL gene rearrangement, 12% （3/25） patients with combined AML/ETO fusion gene, 1 case with NPM1 point mutation and 1 case with P16 gene deletion.ConclusionsTherapy-related hematological neoplasms had a worse prognosis.

关 键 词：肿瘤 继发原发性 血液肿瘤 疾病特征 预后 

分 类 号：R733[医药卫生—肿瘤]