Corti C, Theodore C, Bayle C, Rougier P, Nasr F, Cosset J M, Girinsky T, Hayat M, Ribrag V
Service de Médecine C. Institut Gustave-Roussy, Villejuif, France.
Hematol Oncol. 1996 Dec;14(4):159-63. doi: 10.1002/(SICI)1099-1069(199612)14:4<159::AID-HON586>3.0.CO;2-M.
The incidence of secondary myelodysplastic syndromes (MDS) are rarely reported in an homogeneous patient population treated for non-Hodgkin's lymphoma (NHL). Less than 10 per cent of secondary MDS are usually observed in patients treated for Hodgkin's disease and NHL. Data on the incidence of secondary MDS induced by modern chemotherapeutic regimens is needed. Between January 1985 and January 1989, 20 patients with localized gastric non-Hodgkin's lymphomas (stage I to IIE) were prospectively treated at the Institut Gustave-Roussy with PROMACE-MOPP multi-agent chemotherapy and involved-field irradiation. The mean age was 54 years (range 23 to 69 years). Seven patients died while on therapy or relapsed 2 to 28 months after therapy. Thirteen patients were followed up for at least 5 years. Three of the 13 long-term survivors (23 per cent) developed a myelodysplastic syndrome (MDS) 48, 62 and 72 months after the end of therapy. Cytogenetic analysis was performed in two cases and showed-7 and 18q- in one case, t(9;21)(q13;q22), 21q+, i17q in the other case. PROMACE-MOPP plus radiotherapy should not be recommended in patients with localized gastric non-Hodgkin's lymphoma due to the high risk of developing secondary myelodysplastic syndromes.
在接受非霍奇金淋巴瘤（NHL）治疗的同质患者群体中，继发性骨髓增生异常综合征（MDS）的发病率鲜有报道。在接受霍奇金病和NHL治疗的患者中，通常观察到继发性MDS的比例不到10%。需要有关现代化疗方案诱发继发性MDS发病率的数据。1985年1月至1989年1月期间，20例局限性胃非霍奇金淋巴瘤（I至IIE期）患者在古斯塔夫 - 鲁西研究所接受了PROMACE - MOPP多药化疗及受累野照射的前瞻性治疗。平均年龄为54岁（范围23至69岁）。7例患者在治疗期间死亡或在治疗后2至28个月复发。13例患者接受了至少5年的随访。13例长期存活者中有3例（23%）在治疗结束后48、62和72个月发生了骨髓增生异常综合征（MDS）。对其中2例进行了细胞遗传学分析，1例显示为-7和18q-，另1例显示为t(9;21)(q13;q22)、21q+、i17q。由于发生继发性骨髓增生异常综合征的风险较高，不建议对局限性胃非霍奇金淋巴瘤患者采用PROMACE - MOPP加放疗的治疗方案。
