Sugita K, Furukawa T, Tsuchida M, Okawa Y, Nakazawa S, Akatsuka J, Ohira M, Nishimura K
Second Department of Pediatrics, School of Medicine, Dokkyo University, Tochigi-ken, Japan.
Am J Pediatr Hematol Oncol. 1993 Feb;15(1):99-104. doi: 10.1097/00043426-199302000-00013.
We report patients who were treated for non-Hodgkin's lymphoma (NHL) or Ki-1 antigen-positive (Ki-1) lymphoma with a T-8801 protocol that included etoposide (VP-16) and behenoylcytosine arabinoside.
Secondary acute myeloid leukemia (AML) developed in 5 of 38 NHL and Ki-1 lymphoma patients, and the cumulative risk at 4 years was 18.4%. The median time from the initiation of the chemotherapy to the development of AML was 21 months (range, 13-30). Four patients had a FAB M5 morphology, and one had FAB M2. In four of five examined cases, chromosomal alterations involving the long arm of chromosome 11 were demonstrated at the time of development of AML. None of the 46 NHL patients who we treated with another protocol (B-8801), using significantly higher cumulative doses of VP-16 than in the case of the patients with T-8801 and a different schedule of VP-16 administration, developed secondary AML.
The risk of secondary AML possibly related to the use of VP-16 given twice weekly.
我们报告了采用包含依托泊苷（VP - 16）和山嵛酰阿糖胞苷的T - 8801方案治疗非霍奇金淋巴瘤（NHL）或Ki - 1抗原阳性（Ki - 1）淋巴瘤的患者。
38例NHL和Ki - 1淋巴瘤患者中有5例发生了继发性急性髓系白血病（AML），4年时的累积风险为18.4%。从开始化疗到发生AML的中位时间为21个月（范围13 - 30个月）。4例患者为FAB M5形态，1例为FAB M2。在5例接受检查的病例中，有4例在发生AML时显示出涉及11号染色体长臂的染色体改变。我们用另一种方案（B - 8801）治疗的46例NHL患者中，VP - 16的累积剂量显著高于采用T - 8801方案的患者且VP - 16给药方案不同，这些患者均未发生继发性AML。
继发性AML的风险可能与每周两次给予VP - 16有关。
