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发生治疗相关急性髓系白血病或骨髓增生异常综合征的淋巴瘤患者的特征与结局——波兰成人白血病组的回顾性分析

Characteristics and outcomes of patients with lymphoma who developed therapy-related acute myeloid leukemia or myelodysplastic syndrome - a retrospective analysis of the Polish Adult Leukemia Group.

作者信息

Gołos Aleksandra, Mikulski Damian, Grobelska-Kowalik Monika, Mądry Krzysztof, Lis Karol, Sobas Marta, Ożańska Agnieszka, Czemerska Magdalena, Hawrylecka Dorota, Stelmach-Gołdyś Agnieszka, Chromik Karolina, Puła Bartosz, Sobczyk-Kruszelnicka Małgorzata, Góra-Tybor Joanna

机构信息

Hematology Department, Medical University of Łódź, Łódź, Poland.

Department Of Biostatistics And Translational Medicine, Medical University of Łódź, Łódź, Poland.

出版信息

Contemp Oncol (Pozn). 2024;28(2):149-157. doi: 10.5114/wo.2024.141727. Epub 2024 Jul 24.

Abstract

INTRODUCTION

Enhancing lymphoma outcomes increases the risk of therapy-related neoplasms such as acute myeloid leukemia (t-AML) and myelodysplastic syndrome (t-MDS).

MATERIAL AND METHODS

Our study, conducted at seven Polish hematology centers between 2011 and 2018, explores clinical features, outcomes, and prognostic factors of t-AML and t-MDS arising after initial lymphoid neoplasms.

RESULTS

The analysis included 57 patients of median age 65 with t-MDS ( = 38) and -AML ( = 19). The median time to the onset of -MDS/AML was 58.7 months. The median overall survival (OS) was 16.1 months. The presence of unfavorable cytogenetics and molecular risk factors (HR 2.88, 95% CI: 1.29-6.42, = 0.009), hemoglobin level (HR 0.79, 95% CI: 0.65-0.95, = 0.01) and platelets (HR 0.99, 95% CI: 0.99-0.9996, = 0.03) were independent prognostic factors influencing OS. Therapy- related myelodysplastic syndrome/acute myeloid leukemia after lymphoma treatment is associated with a dismal prognosis mainly due to poor cytogenetic risk.

CONCLUSIONS

Anemia and thrombocytopenia may indicate more severe impairment of bone marrow function, resulting in further inferior treatment outcomes.

摘要

引言

改善淋巴瘤治疗效果会增加治疗相关肿瘤的风险,如急性髓系白血病(t-AML)和骨髓增生异常综合征(t-MDS)。

材料与方法

我们的研究于2011年至2018年在波兰的七个血液学中心进行,探讨了初始淋巴肿瘤后发生的t-AML和t-MDS的临床特征、治疗效果及预后因素。

结果

分析纳入了57例患者,其中t-MDS患者38例,t-AML患者19例,中位年龄为65岁。t-MDS/AML发病的中位时间为58.7个月。中位总生存期(OS)为16.1个月。不良细胞遗传学和分子危险因素的存在(HR 2.88,95%CI:1.29 - 6.42,P = 0.009)、血红蛋白水平(HR 0.79,95%CI:0.65 - 0.95,P = 0.01)和血小板(HR 0.99,95%CI:0.99 - 0.9996,P = 0.03)是影响OS的独立预后因素。淋巴瘤治疗后发生的治疗相关骨髓增生异常综合征/急性髓系白血病预后不佳,主要原因是细胞遗传学风险较差。

结论

贫血和血小板减少可能表明骨髓功能受损更严重,导致治疗效果更差。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e4bd/11480911/e5690857c7ac/WO-28-54508-g001.jpg

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