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同步性双血液系统恶性肿瘤:新的或报道不足的实体?

Synchronous dual hematological malignancies: new or underreported entity?

作者信息

Kotchetkov Rouslan, Ellison Erin, McLean Jesse, Pressnail Bryn, Nay Derek

机构信息

a Simcoe Muskoka Regional Cancer Program , Royal Victoria Regional Health Centre , Barrie , ON , Canada.

b Department of Pathology , Royal Victoria Regional Heath Centre , Barrie , ON , Canada.

出版信息

Hematology. 2018 Oct;23(9):596-599. doi: 10.1080/10245332.2018.1466428. Epub 2018 Jun 7.

Abstract

BACKGROUND

Patients with a single hematological malignancy may be unexpectedly diagnosed with a clonally unrelated synchronous dual hematological malignancy (SDHM). The presence of a secondary hematological malignancy may be overlooked and only identified in situations presenting with discordant clinical or laboratory findings. Clinical management of these patients can be challenging, in part due to the relatively unknown etiopathology of SDHM and the impact of therapy on the secondary malignancy.

OBJECTIVES

To assess, characterize patients with synchronous double hematological malignancies and share our experience with this challenging group of patients.

METHODS

We performed a retrospective chart review of 3036 patients with hematological malignancy at our cancer center between February 2013 and July 2017.

RESULTS AND DISCUSSION

We identified 46 patients with SDHM, a prevalence of 1.51% among patients diagnosed with any hematological malignancy. We identify several heterogeneous combinations of SDHM comprised of myeloid and/or lymphoid lineages and provide our experience with managing patients with these underreported conditions.

CONCLUSION

SDHMs are not uncommon and should be suspected in situations presenting with unusual or unexpected findings.

摘要

背景

患有单一血液系统恶性肿瘤的患者可能会意外地被诊断出患有克隆性不相关的同步双血液系统恶性肿瘤(SDHM)。继发性血液系统恶性肿瘤的存在可能被忽视,仅在出现不一致的临床或实验室检查结果时才被发现。这些患者的临床管理具有挑战性,部分原因是SDHM的病因病理相对不明,以及治疗对继发性恶性肿瘤的影响。

目的

评估和描述同步双血液系统恶性肿瘤患者,并分享我们对这一具有挑战性患者群体的经验。

方法

我们对2013年2月至2017年7月期间在我们癌症中心就诊的3036例血液系统恶性肿瘤患者进行了回顾性病历审查。

结果与讨论

我们识别出46例SDHM患者,在所有诊断为血液系统恶性肿瘤的患者中患病率为1.51%。我们确定了几种由髓系和/或淋巴系组成的SDHM异质性组合,并分享了我们对这些报道不足情况的患者管理经验。

结论

SDHM并不罕见,在出现异常或意外发现的情况下应予以怀疑。

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