癌症与致畸作用：免疫抑制药物医学应用后发生率较低

Cancer and teratogenesis: infrequent occurrence after medical use of immunosuppressive drugs.

作者信息

Symington G R, Mackay I R, Lambert R P

出版信息

Aust N Z J Med. 1977 Aug;7(4):368-72. doi: 10.1111/j.1445-5994.1977.tb04397.x.

DOI:10.1111/j.1445-5994.1977.tb04397.x

Abstract

This study examines long term "medical" immunosuppression with azathioprine or cyclophosphamide for immunopathic disease in relation to cancer and foetal malformation. The experience represent an aggregate of 241 years of treatment and 508 patient-years of follow-up in 133 non-transplant patients. For azathioprine the mean duration of treatment was 1-9 years and the mean duration of observation was 3-8 years, and for cyclophosphamide, the mean durations of treatment and observation were 0-7 and 4-6 years. A sample of 70 patients was shown by in vivo tests to have significantly suppressed cell-mediated immunity. In the period of review there were observed two cancers, both squamous cell carcinomas of skin, two benign neoplasms and six keratoses; after the period of review, three further cancers were recorded, one being in a subject with a known previous cancer. Nine pregnancies with azathioprine yielded no foetal malformations.

摘要

本研究探讨了使用硫唑嘌呤或环磷酰胺进行长期“医学”免疫抑制治疗免疫性疾病与癌症及胎儿畸形的关系。该研究涵盖了133例非移植患者，累计治疗时间达241年，随访时间达508患者年。使用硫唑嘌呤时，平均治疗时间为1至9年，平均观察时间为3至8年；使用环磷酰胺时，平均治疗时间和观察时间分别为0至7年和4至6年。通过体内试验表明，70例患者的细胞介导免疫受到显著抑制。在审查期间，观察到2例癌症，均为皮肤鳞状细胞癌，2例良性肿瘤和6例角化病；审查期过后，又记录到3例癌症，其中1例患者既往已知患有癌症。9例使用硫唑嘌呤的妊娠均未出现胎儿畸形。