9例急性髓系白血病治疗后发生第二肿瘤患者的临床特点分析  

Analysis of clinical features of secondary tumors in nine patients with acute myeloid leukemia after treatment

作　　者：焦扬 王浩 毕利军[2] 许青霞 JIAO Yang;WANG Hao;BI Lijun;XU Qingxia(Department of Clinical Laboratory,The Affiliated Cancer Hospital of Zhengzhou University&Henan Cancer Hospital,Zhengzhou Key Laboratory of Digestive Tumor Markers,Henan Zhengzhou 450008,China;Institute of Biophysics,Chinese Academy of Scineces,Guangdong Foshan 528000,China)

机构地区：[1]郑州大学附属肿瘤医院河南省肿瘤医院检验科郑州市消化系统肿瘤标志物重点实验室,河南郑州450008 [2]中国科学院生物物理所,广东佛山528000

出　　处：《现代肿瘤医学》2024年第3期514-518,共5页Journal of Modern Oncology

基　　金：国家自然科学基金项目(编号:82203572);河南省医学科技攻关计划省部共建重点项目(编号:SBGJ202102070)。

摘　　要：目的:分析急性髓系白血病(acute myeloid leukemia, AML)治疗后发生第二肿瘤患者的临床特点。方法:回顾性分析2012年01月至2021年12月郑州大学附属肿瘤医院诊治的原发AML治疗后发生第二肿瘤9例患者的实验室和临床资料,实验室和临床资料数据通过查阅电子病历系统和实验室数据管理系统获得;采用SPSS 25.0软件进行数据分析。结果:9例AML患者中,8例患者经诱导化疗后达CR,1例患者诱导化疗后未达CR,HSCT后达CRi。9例中第二肿瘤分别为卵巢性索间质肿瘤、肺鳞癌、结肠癌、B细胞淋巴瘤、结肠腺癌、恶性纤维组织细胞瘤/未分化多形性肉瘤、甲状腺微小乳头状癌、神经内分泌肿瘤和肾透明细胞癌。9例患者两种肿瘤诊断时间间隔为12.0(5.0~24.5)个月。随访结束,4例患者稳定治疗中,3例患者第二肿瘤进展死亡,2例患者白血病复发死亡,9例患者中位OS为51个月,除去3例M3患者,中位OS为34个月。结论:AML治疗后发生第二肿瘤,在临床工作中应提高警惕,治疗前后对患者定期进行血常规、肿瘤标志物、基因及影像学等检查,一方面可评估病情,另一方面有助于早期发现第二肿瘤。Objective:To investigate the clinical characteristics of the second tumor in patients with acute myeloid leukemia(AML)after treatment.Methods:The laboratory and clinical data of 9 patients with second tumor after primary AML treatment in the Affiliated Cancer Hospital of Zhengzhou University from January 2012 to December 2021 were retrospectively analyzed.The laboratory and clinical data were obtained by consulting the electronic medical record system and laboratory data management system.SPSS 25.0 software was used for data analysis.Results:Among the 9 patients with AML,8 patients achieved CR after induction chemotherapy,1 patient did not achieve CR after induction chemotherapy,and CRi after HSCT.The second tumors of the 9 patients were ovarian sex cord stromal tumor,lung squamous cell carcinoma,colon cancer,B-cell lymphoma,colorectal adenocarcinoma,malignant fibrous histiocytoma/undifferentiated pleomorphic sarcoma,thyroid micropapillary carcinoma,neuroendocrine tumor,and renal clear cell carcinoma.The diagnostic interval between the two types of tumors in 9 patients was 12.0(5.0~24.5)months.At the end of follow-up,4 patients were in stable treatment,3 patients died of second tumor progression,2 patients died of leukemia recurrence,and the median OS of 9 patients was 51 months,excluding 3 patients with M3,the median OS was 34 months.Conclusion:Patients with AML who develop a second tumor after treatment should be vigilant in clinical work,and regular blood routine,tumor markers,genes and imaging examinations should be performed before and after treatment.On the one hand,it can assess the disease,and on the other hand,it helps to detect the second tumor early.

关 键 词：急性髓系白血病 治疗后 第二肿瘤 临床特点 

分 类 号：R733.71[医药卫生—肿瘤]