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
Hematology Department, Medical University of Łódź, Łódź, Poland.
Department Of Biostatistics And Translational Medicine, Medical University of Łódź, Łódź, Poland.
Contemp Oncol (Pozn). 2024;28(2):149-157. doi: 10.5114/wo.2024.141727. Epub 2024 Jul 24.
Enhancing lymphoma outcomes increases the risk of therapy-related neoplasms such as acute myeloid leukemia (t-AML) and myelodysplastic syndrome (t-MDS).
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.
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.
Anemia and thrombocytopenia may indicate more severe impairment of bone marrow function, resulting in further inferior treatment outcomes.
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）。
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。
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。
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。
