Morales M D, González F A, Villegas A, del Potro E, Díaz Mediavilla J, Martínez R, Alvarez A, Colomé J A
Servicio de Hematología y Hemoterapia, I. Hospital Universitario San Carlos, Madrid.
Sangre (Barc). 1992 Dec;37(6):429-33.
To determine the incidence of a second malignancy in patients with Hodgkin's disease (HD) diagnosed and treated in the same hospital.
A retrospective study was performed on 99 patients diagnosed and treated for HD in the Hospital San Carlos, in Madrid, between January 1976 and december 1987. The clinical records were revised; the diagnosis and staging followed the Rye and Ann Arbor criteria, and the treatment included radiation therapy (RT), chemotherapy (CT), or a combination of both. The diagnosis of the second malignancy was based upon clinical, analytical, radiological and histological records.
The median age in the series was 31 years (16-82) and the M/F ratio was 61/38. The stage distribution was: I-9; II-29; III-31, and IV-30. Twenty-six patients received RT alone, 59 were treated with CT, and 14 received RT plus CT. A second neoplasm was found in 6 patients (6%), of whom 4 developed a myelodysplastic syndrome (MDS) and 2 a solid tumour. All the patients who had MDS had received MOPP or C-MOPP chemotherapy, associated in two of them with extensive RT. Both patients with solid tumour had been given CT+RT. The median time of presentation of the second malignancy since the diagnosis od HD was 89 months (48-174) for MDS and 120 months for the solid tumours. The four MDS patients have died, 2 for ANLL-M5, one for SRA and the remainder for cerebral haemorrhage, not yet evolved into acute leukaemia. The two patients which solid tumours are alive and seemingly in complete remission at 12 and 10 months, respectively, of the diagnosis of the second malignancy.
确定在同一家医院诊断和治疗的霍奇金病（HD）患者中发生第二种恶性肿瘤的发生率。
对1976年1月至1987年12月期间在马德里圣卡洛斯医院诊断和治疗的99例HD患者进行了一项回顾性研究。查阅了临床记录；诊断和分期遵循赖伊和安阿伯标准，治疗包括放射治疗（RT）、化学治疗（CT）或两者联合。第二种恶性肿瘤的诊断基于临床、分析、放射学和组织学记录。
该系列患者的中位年龄为31岁（16 - 82岁），男女比例为61/38。分期分布为：I期 - 9例；II期 - 29例；III期 - 31例，IV期 - 30例。26例患者仅接受了RT，59例接受了CT治疗，14例接受了RT加CT治疗。6例患者（6%）发现了第二种肿瘤，其中4例发展为骨髓增生异常综合征（MDS），2例为实体瘤。所有发生MDS的患者均接受了MOPP或C - MOPP化疗，其中2例还联合了广泛的RT。2例实体瘤患者均接受了CT + RT治疗。自HD诊断以来出现第二种恶性肿瘤的中位时间，MDS为89个月（48 - 174个月），实体瘤为120个月。4例MDS患者已死亡，2例死于急性非淋巴细胞白血病M5型，1例死于严重再生障碍性贫血，其余死于脑出血，尚未发展为急性白血病。2例实体瘤患者存活，分别在第二种恶性肿瘤诊断后的12个月和10个月时似乎处于完全缓解状态。
1）所有发生第二种肿瘤的患者此前均接受过CT（MOPP或C - MOPP）或CT + RT治疗。2）该系列中没有任何患者出现非霍奇金淋巴瘤。3）对HD患者进行长期随访似乎很重要，以便早期诊断其他恶性并发症，尽管MDS预后较差，但实体瘤在适当治疗下可能预后良好。
