Tam Constantine S, Seymour John F, Prince H Miles, Kenealy Melita, Wolf Max, Januszewicz E Henry, Westerman David
Department of Haematology, Peter MacCallum Cancer Centre, Melbourne, Australia.
Haematologica. 2006 Nov;91(11):1546-50.
Although myelodysplasia (MDS) and secondary acute myeloid leukemia (sAML) are rare following fludarabine monotherapy, the risk of these diseases may potentially be increased when fludarabine is combined with cyclophosphamide or mitoxantrone due to synergistic effects on the inhibition of DNA repair. Among 137 patients treated with fludarabine combination regimens, ten patients developed MDS/sAML, including one who had received no other therapy. Six patients had abnormalities of chromosomes 5 and/or 7. The crude rate of MDS/sAML was 2.5% for previously untreated patients, and 9.3% for pretreated patients (p=0.28). The rate of MDS/sAML following fludarabine combination therapy is higher than that previously reported for fludarabine monotherapy.
虽然氟达拉滨单药治疗后骨髓增生异常综合征（MDS）和继发性急性髓系白血病（sAML）较为罕见，但由于氟达拉滨与环磷酰胺或米托蒽醌联合使用时对DNA修复抑制具有协同作用，这些疾病的风险可能会增加。在137例接受氟达拉滨联合方案治疗的患者中，有10例发生了MDS/sAML，其中1例未接受过其他治疗。6例患者存在5号和/或7号染色体异常。既往未治疗患者的MDS/sAML粗发病率为2.5%，既往接受过治疗患者为9.3%（p = 0.28）。氟达拉滨联合治疗后MDS/sAML的发病率高于先前报道的氟达拉滨单药治疗。
