Bhatia Prateek, Das Reena, Ahluwalia Jasmina, Malhotra Pankaj, Varma Neelam, Varma S, Sharma S C, Garewal Gurjeewan
Department of Haematology, PGIMER, Chandigarh, India.
Indian J Pathol Microbiol. 2009 Apr-Jun;52(2):167-70. doi: 10.4103/0377-4929.48908.
A second malignant neoplasm has been found to be more frequent than might be expected from the general population rates. Therapy-related myelodysplastic syndrome and acute leukemia are dreaded long-term complications of five cases of hematological malignancies following treatment for successful breast cancer therapy (therapeutic drugs or radiotherapy). We encountered carcinoma from north India over a 7-year period from 1999 to 2005. The patients presented 2-5 years after treatment of breast carcinoma. Three patients underwent surgery and received chemoradiotherapy. One patient received chemotherapy after surgery. One patient underwent only surgery and after 3 years presented with acute myeloid leukemia and bone marrow metastasis of carcinoma of the breast. At the time of presentation, all the patients had either bicytopenia or pancytopenia. A close follow-up with complete blood cell counts of the patients who previously had carcinoma of the breast is suggested for early detection of hematological abnormalities. However, the poor prognosis, limited financial resources and poor health insurance coverage results in few patients and their family members opting for treatment.
已发现第二种恶性肿瘤比根据一般人群发病率预期的更为常见。治疗相关的骨髓增生异常综合征和急性白血病是五例乳腺癌成功治疗（治疗药物或放疗）后血液系统恶性肿瘤令人恐惧的长期并发症。我们在1999年至2005年的7年期间遇到了来自印度北部的癌症患者。这些患者在乳腺癌治疗后2至5年出现症状。三名患者接受了手术并接受了放化疗。一名患者在手术后接受了化疗。一名患者仅接受了手术，3年后出现急性髓性白血病和乳腺癌骨髓转移。在就诊时，所有患者均有双系血细胞减少或全血细胞减少。建议对既往有乳腺癌的患者进行密切随访并检测全血细胞计数，以便早期发现血液学异常。然而，预后不良、财政资源有限和医疗保险覆盖不足导致很少有患者及其家属选择治疗。
