Osteosarcoma after allogeneic bone marrow transplantation.: A report of four cases from the Cooperative Osteosarcoma Study Group (COSS)
Osteosarcoma after allogeneic bone marrow transplantation.: A report of four cases from the Cooperative Osteosarcoma Study Group (COSS)
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DOI：
10.1038/sj.bmt.1703864
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发表时间：
2003-03-01
影响因子：
4.8
通讯作者：
Jürgens, H
中科院分区：
文献类型：
--
作者：
Bielack, SS;Rerin, JS;Jürgens, H
骨肉瘤是年轻癌症患者治疗后最常见的继发性恶性肿瘤之一，与造血干细胞移植(HSCT)相关的病例很少。我们报告了四名患者，他们是通过搜索合作骨肉瘤研究小组(COSS)的数据库来确定HSCT后发生骨肉瘤的患者的。移植适应证为急性淋巴细胞白血病(3例)和镰状细胞病(1例)，所有病例的干细胞来源均为骨髓(3例异基因，1例同基因)。作为调理方案和/或一线治疗的一部分，所有四人都接受了烷化剂化疗。调理方案包括3名患者的全身照射。骨肉瘤发生在该疾病的典型年龄(青春期)和部位(膝盖周围)。所有4名患者均接受化疗，作为多模式骨肉瘤治疗的一部分，所有4名患者目前均存活，其中3名患者在57/12、2 11/12和0 6/12年持续缓解，1名骨肉瘤患者在4 1/12年内复发。其中一名没有骨肉瘤的幸存者患上了第三种恶性肿瘤，骨髓增生异常综合征。骨肉瘤应包括在HSCT后可能发生的继发性恶性肿瘤中。根据新发骨肉瘤指南进行的多模式治疗可以在选定的患者中导致长期生存。
Osteosarcoma, one of the most frequent secondary malignancies after the treatment of young patients with cancer, has only very rarely been observed in association with hematopoietic stem cell transplantation (HSCT). We report four patients who were identified by searching the database of the Cooperative Osteosarcoma Study Group (COSS) for patients whose osteosarcoma arose following HSCT. Transplant indications had been acute lymphoblastic leukemia (3) and sickle cell disease (1), and the stem cell source was bone marrow in all cases (three allogeneic, one syngeneic). All four had received chemotherapy with alkylators as part of their conditioning regimen and/or first line therapy. The conditioning regimen included total body irradiation in three patients. The osteosarcomas arose at the age (adolescence) and sites (around the knee) typical for the disease. All four patients received chemotherapy as part of multimodal osteosarcoma treatment, and all four are currently alive, three in continuous remission at 5 7/12, 2 11/12, and 0 6/12 years and one with relapsed osteosarcoma at 4 1/12 years. One of the osteosarcoma-free survivors suffered a third malignancy, myelodysplastic syndrome. Osteosarcoma should be included among the secondary malignancies that can arise following HSCT. Multimodal therapy according to guidelines for de novo osteosarcoma can lead to long-term survival in selected patients.