Pedersen-Bjergaard J, Ersbøll J, Sørensen H M, Keiding N, Larsen S O, Philip P, Larsen M S, Schultz H, Nissen N I
Ann Intern Med. 1985 Aug;103(2):195-200. doi: 10.7326/0003-4819-103-2-195.
Of 602 patients treated for non-Hodgkin's lymphomas, 9 developed overt acute nonlymphocytic leukemia or preleukemia with refractory cytopenia and cytogenetic abnormalities of the bone marrow. A Kaplan-Meier estimate of the cumulative probability of leukemic complications was 6.3 +/- 2.6% (mean +/- SE) 7 years after start of treatment. All 9 patients with leukemic complications belong to a major subgroup of 498 patients treated with alkylating agents, predominantly cyclophosphamide. The risk of leukemic complications in this subgroup was compared with the risk in 312 patients treated with other alkylating agents for Hodgkin's disease, and with the risk in 553 patients treated with dihydroxybusulfan for ovarian carcinoma. Cumulative 9-year risks were 8.0 +/- 3.3%, 12.8 +/- 3.5%, and 7.1 +/- 1.9%, respectively. The general risk of secondary leukemia after long-term treatment with alkylating agents ranges from 1% to 1.5% per year from 2 to at least 9 years after start of treatment.
在602例接受非霍奇金淋巴瘤治疗的患者中，9例发生了明显的急性非淋巴细胞白血病或伴有难治性血细胞减少和骨髓细胞遗传学异常的白血病前期。治疗开始7年后，白血病并发症累积概率的Kaplan-Meier估计值为6.3±2.6%（均值±标准误）。所有9例有白血病并发症的患者均属于接受烷化剂治疗的498例主要亚组，主要使用环磷酰胺。将该亚组白血病并发症的风险与312例接受其他烷化剂治疗霍奇金病的患者以及553例接受二羟基白消安治疗卵巢癌的患者的风险进行了比较。9年累积风险分别为8.0±3.3%、12.8±3.5%和7.1±1.9%。烷化剂长期治疗后继发性白血病的总体风险在治疗开始后2至至少9年期间为每年1%至1.5%。
