131I-间碘苄胍治疗复发性神经母细胞瘤后发生的继发性骨髓增生异常综合征和白血病。
Secondary myelodysplastic syndrome and leukemia following 131I-metaiodobenzylguanidine therapy for relapsed neuroblastoma.
作者信息
Weiss Brian, Vora Amish, Huberty John, Hawkins Randall A, Matthay Katherine K
机构信息
Department of Pediatrics, M647, University of California San Francisco, 505 Parnassus, San Francisco, CA 94143-0106, USA.
出版信息
J Pediatr Hematol Oncol. 2003 Jul;25(7):543-7. doi: 10.1097/00043426-200307000-00009.
PURPOSE
To describe three patients with secondary leukemia after treatment with 131I-metaiodobenzylguanidine (MIBG) for neuroblastoma.
METHODS
Of 95 children with refractory neuroblastoma treated with 131I-MIBG at UCSF, 3 have been identified with secondary myelodysplasia/leukemia. The case records and bone marrow results were reviewed, along with a review of the literature.
RESULTS
Three patients developed secondary myelodysplasia/leukemia, at 7, 11, and 12 months following 131I-MIBG therapy. Cytogenetic abnormalities included -7q/-5, -7/+2q37, -11 and +12. Three additional cases were found in literature review of 509 reported patients treated with 131I-MIBG for neuroblastoma.
CONCLUSIONS
Therapy with 131I-MIBG may contribute to the risk of secondary leukemia in patients who have received intensive chemotherapy, thought the risk of this complication is far lower than the risk of disease progression. Further monitoring for this complication is indicated.
目的
描述3例经131I-间碘苄胍（MIBG）治疗神经母细胞瘤后发生继发性白血病的患者。
方法
在加州大学旧金山分校接受131I-MIBG治疗的95例难治性神经母细胞瘤患儿中，有3例被确诊为继发性骨髓发育异常/白血病。回顾了病例记录和骨髓检查结果，并对文献进行了综述。
结果
3例患者在接受131I-MIBG治疗后7、11和12个月发生继发性骨髓发育异常/白血病。细胞遗传学异常包括-7q/-5、-7/+2q37、-11和+12。在对509例接受131I-MIBG治疗神经母细胞瘤的报道患者进行文献综述时又发现了3例。
结论
131I-MIBG治疗可能会增加接受过强化化疗患者发生继发性白血病的风险，不过这种并发症的风险远低于疾病进展的风险。有必要对这种并发症进行进一步监测。
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