Boshoff C, Begent R H, Oliver R T, Rustin G J, Newlands E S, Andrews R, Skelton M, Holden L, Ong J
Royal London Hospital, U.K.
Ann Oncol. 1995 Jan;6(1):35-40. doi: 10.1093/oxfordjournals.annonc.a059037.
Reports have implied etoposide as the cause of secondary leukaemia in patients treated for germ cell cancer.
Between 1979 and 1992, 679 male patients with germ cell cancer received etoposide containing chemotherapy.
Six of 679 patients developed acute myeloid leukaemia (relative risk 150; CI: 55-326). None of these patients had a primary mediastinal germ cell tumour and only 1 patient received previous radiotherapy. The median interval between the onset of cytotoxic treatment and the development of leukaemia was 27 months. The FAB M4 morphology was seen in 4 of 6 cases.
The benefit of etoposide containing protocols outweigh the risk of leukaemia in patients with intermediate or high risk disease, however in patients with good risk disease non-etoposide containing protocols should be explored.
有报告指出，接受生殖细胞癌治疗的患者中，依托泊苷是继发性白血病的病因。
1979年至1992年间，679例男性生殖细胞癌患者接受了含依托泊苷的化疗。
679例患者中有6例发生急性髓系白血病（相对风险150；可信区间：55 - 326）。这些患者均无原发性纵隔生殖细胞肿瘤，只有1例患者曾接受过放疗。细胞毒性治疗开始至白血病发生的中位间隔时间为27个月。6例中有4例表现为FAB M4形态。
对于中高危疾病患者，含依托泊苷方案的益处超过白血病风险；然而，对于低危疾病患者，应探索不含依托泊苷的方案。
