Rubin C M, Arthur D C, Woods W G, Lange B J, Nowell P C, Rowley J D, Nachman J, Bostrom B, Baum E S, Suarez C R
Department of Pediatrics, University of Chicago, IL.
Blood. 1991 Dec 1;78(11):2982-8.
We have studied 20 children with therapy-related myelodysplastic syndrome (MDS) or acute myeloid leukemia (AML) who were 3 months to 16 years old at diagnosis of their primary neoplasm and 1 to 24 years old at diagnosis of their secondary neoplasm. The median interval from initial treatment for the first malignancy to diagnosis of therapy-related MDS or AML was 46 months (range, 12 to 116 months). Twelve patients had chromosomal abnormalities resulting in loss of material from the long arm of chromosomes 5 and/or 7, three patients had abnormalities of chromosome 11 band q23, one patient had both classes of abnormalities, three patients had other abnormalities, and one patient had a normal karyotype. Ten of 12 patients with chromosome 5 and/or 7 abnormalities had been exposed to an alkylating agent, and two of three patients with 11q23 abnormalities had been exposed to an epipodophyllotoxin. The patient with both classes of abnormalities had been exposed to both types of therapy. We conclude that abnormalities of chromosomes 5 and/or 7 are common in children with therapy-related MDS or AML. The proposed relationships between exposure to alkylating agents and abnormalities of chromosomes 5 and/or 7 and between exposure to epipodophyllotoxins and abnormalities of 11q23 are supported in this pediatric series.
我们研究了20例与治疗相关的骨髓增生异常综合征（MDS）或急性髓系白血病（AML）患儿，这些患儿初次肿瘤诊断时年龄为3个月至16岁，二次肿瘤诊断时年龄为1至24岁。从首次恶性肿瘤的初始治疗到诊断为与治疗相关的MDS或AML的中位间隔时间为46个月（范围12至116个月）。12例患者存在染色体异常，导致5号和/或7号染色体长臂物质缺失；3例患者存在11号染色体q23带异常；1例患者同时存在这两类异常；3例患者存在其他异常；1例患者核型正常。12例5号和/或7号染色体异常的患者中有10例曾接触过烷化剂，3例11q23异常的患者中有2例曾接触过表鬼臼毒素。同时存在这两类异常的患者曾接触过这两种治疗。我们得出结论，5号和/或7号染色体异常在与治疗相关的MDS或AML患儿中很常见。本儿科系列研究支持了所提出的接触烷化剂与5号和/或7号染色体异常之间以及接触表鬼臼毒素与11q23异常之间的关系。
