Therapy-related acute myeloid leukemia and myelodysplasia after high-dose chemotherapy and autologous stem cell transplantation.
Therapy-related acute myeloid leukemia and myelodysplasia after high-dose chemotherapy and autologous stem cell transplantation.
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大剂量化疗和自体干细胞移植后治疗相关的急性髓系白血病和骨髓增生异常。
DOI：
10.1182/blood.v95.11.3273
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发表时间：
2000
期刊：
影响因子：
20.3
通讯作者：
D. Christiansen
中科院分区：
文献类型：
--
作者：
J. Pedersen‐Bjergaard;M. Andersen;D. Christiansen
恶性疾病大剂量化疗(HD-CT)和自体干细胞移植(ASCT)后的治疗相关性骨髓增生异常(t-MDS)和急性髓系白血病(t-AML)已经成为一个重要的问题。精算风险各不相同，但与常规治疗后的风险相比，精算风险往往很高。化疗前使用大剂量烷化剂是最重要的危险因素。此外，患者年龄和既往放射治疗，特别是在ASCT准备方案中使用全身照射(TBI)，已被确定为危险因素。在3项研究中，化疗启动后外周血CD34(+)细胞移植的患者发生t-MDS或t-AML的风险高于未启动的骨髓分离细胞移植患者。这种较高的风险在多大程度上与先前治疗时两种方法获得的CD34(+)细胞的造血前体细胞受到不同的污染有关，或者是化疗启动的直接结果，或者是对这些并发症认识的提高，仍有待确定。从ASCT到t-MDS和t-AML的潜伏期通常很短，27%的患者潜伏期在12个月或更短。ASCT后早期t-MDS的骨髓病理往往既不能诊断，也不能预测预后，但大多数患者表现为染色体异常，主要是5号和7号染色体长臂的缺失或丢失。预后一般较差，尽管17%的惰性t-MDS患者从诊断到确诊后存活超过18个月，且大多数为正常核型或单个染色体异常。
Therapy-related myelodysplasia (t-MDS) and acute myeloid leukemia (t-AML) after high-dose chemotherapy (HD-CT) and autologous stem cell transplantation (ASCT) for malignant diseases have become an important problem. The actuarial risk has varied, but has often been high if compared to the risk after conventional therapy. Prior chemotherapy with large cumulative doses of alkylating agents is the most important risk factor. In addition, patient age and previous radiotherapy, particularly the use of total body irradiation (TBI) in the preparative regimen for ASCT, have been identified as risk factors. In 3 studies, patients transplanted with CD34(+ )cells from peripheral blood after chemotherapy priming showed a higher risk of t-MDS or t-AML than patients transplanted with cells isolated from the bone marrow without priming. To what extent this higher risk relates to the prior therapy with a different contamination with preleukemic, hematopoietic precursors of the CD34(+) cells obtained by the 2 methods, or is a direct result of chemotherapy priming, or of an increasing awareness of these complications, remains to be determined. The latent period from ASCT to t-MDS and t-AML has often been short, 12 months or less in 27% of the patients. Bone marrow pathology of early cases of t-MDS after ASCT has often been neither diagnostic nor prognostic, but most patients presented chromosome aberrations, primarily deletions or loss of the long arms of chromosomes 5 and 7. The prognosis was in general poor, although 17% with indolent t-MDS survived more than 18 months from diagnosis, and most of these presented a normal karyotype or a single chromosome aberration.
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霍奇金病自体骨髓移植前骨髓细胞遗传学评估的重要性。
DOI：
10.1200/jco.1991.9.9.1575
发表时间：
1991
期刊：
Journal of clinical oncology : official journal of the American Society of Clinical Oncology
影响因子：
--
作者：
Chao,NJ;Nademanee,AP;Long,GD;Schmidt,GM;Donlon,TA;Parker,P;Slovak,ML;Nagasawa,LS;Blume,KG;Forman,SJ
通讯作者：
Forman,SJ
淋巴瘤自体骨髓移植后发生骨髓增生异常综合征。
影响因子：
3.5
作者：
Wilson,CS;Traweek,ST;Slovak,ML;Niland,JC;Forman,SJ;Brynes,RK
通讯作者：
Brynes,RK
自体骨髓移植后的骨髓增生异常综合征：治愈性癌症治疗的另一个晚期并发症。
影响因子：
20.3
作者：
Miller,JS;Arthur,DC;Litz,CE;Neglia,JP;Miller,WJ;Weisdorf,DJ
通讯作者：
Weisdorf,DJ
影响因子：
158.5
作者：
PUI, CH;BEHM, FG;WILLIAMS, DL
通讯作者：
WILLIAMS, DL
影响因子：
45.3
作者：
LEBEAU, MM;ALBAIN, KS;ROWLEY, JD
通讯作者：
ROWLEY, JD