Waldman Dalia, Weintraub Michael, Freeman Arnold, Neumann Yoram, Rechavi Gideon, Toren Amos
Pediatric Hematology-Oncology Department, The Chain Sheba Medical Center, Tel-Hashomer, Affiliated to the Sackler School of Medicine,Tel-Aviv University, Israel.
Am J Hematol. 2004 Apr;75(4):217-9. doi: 10.1002/ajh.20027.
Second malignant neoplasms are gradually becoming a recognized long-term complication of successful cancer treatment, and they usually respond poorly to conventional therapy and have an unfavorable outcome. Chronic myeloid leukemia (CML) is a clonal panmyelopathy, rarely seen in children with a specific cytogenetic aberration-the Philadelphia chromosome. The translocation generates an aberrant tyrosine kinase, which drives the malignant process in CML and which is also the molecular target for successful treatment of CML with imatinib. It is also exceedingly rare as a secondary malignant neoplasm in both adults and children. We report two cases of secondary CML. The first occurred after successful treatment for nasopharyngeal carcinoma in a child, and the second after treatment for lymphoma in an adolescent. Both patients had an excellent response to treatment with imatinib and attained complete cytogenetic remissions. We conclude that secondary CML may respond favorably to treatment with imatinib.
第二原发性恶性肿瘤正逐渐成为成功治疗癌症后一种公认的长期并发症，它们通常对传统疗法反应不佳且预后不良。慢性髓性白血病（CML）是一种克隆性全髓增殖病，在患有特定细胞遗传学异常——费城染色体的儿童中很少见。这种易位产生一种异常酪氨酸激酶，它驱动CML中的恶性进程，也是用伊马替尼成功治疗CML的分子靶点。作为成人和儿童的继发性恶性肿瘤，它也极其罕见。我们报告两例继发性CML病例。第一例发生在一名儿童鼻咽癌成功治疗后，第二例发生在一名青少年淋巴瘤治疗后。两名患者对伊马替尼治疗均有良好反应并实现了完全细胞遗传学缓解。我们得出结论，继发性CML可能对伊马替尼治疗反应良好。
