First Department of Internal Medicine, University Hospital of Cologne, Cologne, Germany.
Mediterr J Hematol Infect Dis. 2011;3(1):e2011046. doi: 10.4084/MJHID.2011.046. Epub 2011 Oct 24.
Hodgkin lymphoma (HL) is a malignancy of the lymphatic system with an incidence of 2-3/100.000/year in developed countries. With modern multi-agent chemotherapy protocols optionally combined with radiotherapy (RT), 80% to 90% of HL patients achieve long-term remission and can be considered cured. However, current standard approaches bear a considerable risk for the development of treatment-related late effects. Thus, one major focus of current clinical research in HL is reducing the incidence of these late effects that include heart failure, infertility, chronic fatigue and therapy-related myelodysplastic syndrome/acute myeloid leukemia (t-MDS/t-AML). In previous analyses, t-MDS/t-AML after treatment for HL was associated with a poor prognosis. Nearly all patients died rapidly after diagnosis. However, more recent analyses indicated an improved outcome among patients with t-MDS/t-AML who are eligible for modern anti-leukemic treatment and allogeneic stem cell transplantation (aSCT). This article gives an overview of recent reports on the incidence and the treatment of t-MDS/t-AML after HL therapy and describes the efforts currently made to reduce the risk to develop this severe late effect.
霍奇金淋巴瘤（HL）是一种淋巴系统恶性肿瘤，在发达国家的发病率为 2-3/100.000/年。随着现代多药物化疗方案可选联合放疗（RT）的应用，80%至 90%的 HL 患者实现了长期缓解，可以认为已被治愈。然而，目前的标准治疗方法存在发生治疗相关晚期效应的相当大风险。因此，HL 目前临床研究的一个主要重点是降低这些晚期效应的发生率，包括心力衰竭、不孕、慢性疲劳和治疗相关骨髓增生异常综合征/急性髓系白血病（t-MDS/t-AML）。在以前的分析中，HL 治疗后发生的 t-MDS/t-AML 与预后不良相关。几乎所有患者在诊断后迅速死亡。然而，最近的分析表明，对于符合现代抗白血病治疗和异基因造血干细胞移植（aSCT）条件的 t-MDS/t-AML 患者，其预后得到了改善。本文概述了最近关于 HL 治疗后 t-MDS/t-AML 的发生率和治疗的报告，并描述了目前为降低发生这种严重晚期效应的风险所做的努力。
