Mougeot-Martin M, Krulik M, Harousseau J L, Audebert A A, Chaouat Y, Debray J
Ann Med Interne (Paris). 1978 Mar;129(3):175-80.
On the basis of two personal cases of acute leukaemia occurring following immunosuppressive therapy for disseminated sclerosis and for Behçet's syndrome, the literature is reviewed. Thirty three similar detailed cases were collected. They are characterised in general by the prolonged use of immunosuppression. The acute leukaemia affected the granulocyte series in the majority of cases. In 30%; the leukaemia was preceded by a phase of several months of preleukaemic type dysmyelopoiesis. The mechanisms of action explaining this carcinogenic risk in a general way are multiple: the role of marrow aplasia, chromosomal abnormalities, the activation of a leukaemogenic virus, the role of immunodepression and that of repeated antigenic stimulation may all be discussed. The risks associated with such treatment should thus be borne in mind when evaluating its indications.
基于两例分别在针对多发性硬化症和白塞氏综合征进行免疫抑制治疗后发生急性白血病的个人病例，对相关文献进行了综述。收集了33例类似的详细病例。这些病例的总体特征是长期使用免疫抑制剂。大多数病例中急性白血病累及粒细胞系。30%的病例中，白血病之前有数个月的白血病前期骨髓异常造血阶段。总体解释这种致癌风险的作用机制是多方面的：骨髓再生障碍的作用、染色体异常、致白血病病毒的激活、免疫抑制的作用以及反复抗原刺激的作用都值得探讨。因此，在评估此类治疗的适应证时应牢记与之相关的风险。
