Hatakeyama S, Kohmura K, Ebe T
Department of Respiratory Medicine, Nagaoka Red Cross Hospital, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1990 Nov;28(11):1488-93.
A myelo dysplastic syndrome (MDS), refractory anemia with excess of blasts (RAEB), that occurred in a patient with small cell lung cancer (SCLC) during a period of complete response (CR) was reported. A 66-year-old female patient was diagnosed as SCLC in March, 1985. Induction chemotherapy (CDDP, ADM, VCR, VP-16) achieved CR in May, 1985. She had received maintenance chemotherapy (CDDP, ADM, VCR (or VDS), VP-16) and chest irradiation (48.6 Gy) until May, 1988. The hematologic findings revealed MDS and she was admitted in June, 1989. She died one month after onset of MDS because of pneumonia. An autopsy showed no evidence of recurrence of small cell carcinoma in the primary site and other organs. There is a possibility of the risk of secondary leukemia following long term chemotherapy and irradiation in patients with SCLC, and the role of treatment after the achievement of CR in patients with SCLC remains to be clarified.
报告了1例小细胞肺癌(SCLC)患者在完全缓解(CR)期发生的骨髓增生异常综合征(MDS),即伴有过多原始细胞的难治性贫血(RAEB)。一名66岁女性患者于1985年3月被诊断为SCLC。诱导化疗(顺铂、阿霉素、长春新碱、依托泊苷)于1985年5月达到CR。她接受维持化疗(顺铂、阿霉素、长春新碱(或长春地辛)、依托泊苷)和胸部放疗(48.6 Gy)直至1988年5月。血液学检查结果显示为MDS,她于1989年6月入院。她在MDS发病后1个月因肺炎死亡。尸检显示在原发部位和其他器官未发现小细胞癌复发的证据。SCLC患者长期化疗和放疗后有发生继发性白血病的风险,SCLC患者达到CR后的治疗作用仍有待阐明。