Detection of chromosome abnormalities pre-high-dose treatment in patients developing therapy-related myelodysplasia and secondary acute myelogenous leukemia after treatment for non-Hodgkin's lymphoma.
Detection of chromosome abnormalities pre-high-dose treatment in patients developing therapy-related myelodysplasia and secondary acute myelogenous leukemia after treatment for non-Hodgkin's lymphoma.
复制标题
对非霍奇金淋巴瘤治疗后发生治疗相关骨髓增生异常和继发性急性髓性白血病的患者进行高剂量治疗前染色体异常的检测。
DOI：
10.1200/jco.2001.19.9.2472
复制
发表时间：
2001
期刊：
影响因子：
--
通讯作者：
A. Rohatiner
中科院分区：
文献类型：
--
作者：
D. Lillington;I. Micallef;E. Carpenter;M. Neat;J. Amess;J. Matthews;N. Foot;B. Young;T. Lister;A. Rohatiner
目的
评估高剂量治疗前（HDT）相关因素是否在治疗相关骨髓增生异常（tMDS）或继发性急性髓细胞性白血病（sAML）的发生中起关键作用。
患者和方法
初步诊断为非霍奇金淋巴瘤（NHL）的230名患者中的29名在包括环磷酰胺和由自体造血祖细胞支持的全身照射（TBI）的HDT后发展tMDS/sAML。G显带和荧光原位杂交（FISH）检测克隆性细胞遗传学异常。
结果
大多数患者在诊断tMDS/sAML时显示复杂的核型，特别是5号和/或7号染色体的完全或部分缺失。使用单一位点特异性FISH探针，在HDT后中位随访5.9年时，在20/20例接受筛查的tMDS/sAML患者中发现了HDT前显著水平的克隆异常细胞，而在24例接受筛查的患者中有3例目前未发生tMDS/sAML。
结论
既往细胞毒性治疗可能在病因学方面发挥重要作用，并可能易导致tMDS/sAML的发生。使用设计用于检测5 q31、7 q22或13 q14染色体物质丢失的三重FISH检测，可以在HDT之前检测到显著水平的异常细胞，并可以预测哪些患者发生继发性疾病的风险增加。进一步的前瞻性评估，这种FISH检测是必要的，以确定其在这种情况下的预测能力。
PURPOSE
To assess whether pre-high-dose therapy (HDT)-related factors play a critical role in the development of therapy-related myelodysplasia (tMDS) or secondary acute myelogenous leukemia (sAML).
PATIENTS AND METHODS
Twenty-nine of 230 patients with a primary diagnosis of non-Hodgkin's lymphoma (NHL) developed tMDS/sAML after HDT comprising cyclophosphamide and total-body irradiation (TBI) supported by autologous hematopoietic progenitor cells. G-banding and fluorescence in-situ hybridization (FISH) were used to detect clonal cytogenetic abnormalities.
RESULTS
The majority of patients showed complex karyotypes at diagnosis of tMDS/sAML containing, in particular, complete or partial loss of chromosomes 5 and/or 7. Using single locus-specific FISH probes, significant levels of clonally abnormal cells were found before HDT in 20 of 20 tMDS/sAML patients screened, compared with three of 24 patients screened who currently have not developed tMDS/sAML, at a median follow-up of 5.9 years after HDT.
CONCLUSION
Prior cytotoxic therapy may play an important etiologic role and may predispose to the development of tMDS/sAML. Using a triple FISH assay designed to detect loss of chromosomal material from 5q31, 7q22, or 13q14, significant levels of abnormal cells can be detected before HDT and may predict which patients are at increased risk of developing secondary disease. Further prospective evaluation of this FISH assay is warranted to determine its predictive power in this setting.
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