Alkylating Agent 增加 白血病風險 !!

烷化剂可增加治疗相关性白血病风险 发布时间：2013-1-17 来源：药品资讯网信息中心1月7日发表在《临床肿瘤学》杂志上的一项研究显示，霍奇金氏淋巴瘤(HL)患者不断使用烷化剂(AA)会增加自己患治疗相关性白血病/骨髓增生异常综合征(t-AML/MDS)的风险。斯坦福大学医学中心教授Michael Zach Koontz和同事们对754名从1974年到2003年间接受霍奇金氏淋巴瘤治疗的患者的医学记录进行了评审，这些患者在完成一系列治疗后，医生对其进行了至少5年的跟踪观察。参与S研究(1974年-1980年)和C研究(1981年-1989年)的患者采用了大范围放射疗法，而G研究(1989年-2003年)中的患者则进行了相关区域放疗，此外，这些研究所采用的主要化学疗法也不尽相同。经过分析之后研究人员发现，G研究中的患者接触烷化剂的量要比S和C研究中患者所接触的量小很多，其中，氮芥类药物的剂量少75%-83%，而甲基苄肼和左旋苯丙氨酸氮芥的使用量为零。24名患者出现了t-AML/MDS,其中15名是在接受完主要化疗之后患上的，而剩下9名则是在进行完针对于复发性HL的化疗后出现的。G研究中患者的t-AML/MDS发病率仅为0.3%，而这一比例在S研究和C研究患者中则高达5.7%和5.2%。G研究中的患者在完成主要化疗之后没有再出现t-AML/MDS病例，而在二线治疗结束后，G研究中只有1名患者出现了t-AML/MDS.研究人员表示："我们的研究数据证实了烷化剂使用的不断积累与t-AML/MDS之间存在联系。t-AML/MDS患者的预后往往不理想，当务之急是研发出可降低这些风险的疗法。"

Alkylating Agent Linked to Therapy-Related Leukemia

January 15, 2013 (HealthDay News) – For patients treated for Hodgkin's lymphoma (HL), cumulative doses of alkylating agent (AA) is associated with the risk of therapy-related acute myeloid leukemia/myelodysplastic syndrome (t-AML/MDS), according to a study published online Jan. 7 in the Journal of Clinical Oncology. Michael Zach Koontz, MD, from the Stanford University Medical Center in California, and colleagues reviewed the records of 754 patients with HL (treated from 1974–2003) with at least five years of follow-up after completing therapy in successive generations of Stanford clinical trials. S studies (1974–1980) and C studies (1981–1989) utilized extended-field radiotherapy, while G studies (1989–2003) utilized involved-field radiotherapy. Primary chemotherapies varied by study. The researchers found that, in the G studies, the cumulative exposure to AA was substantially lower than in the S and C studies, with a 75%–83% lower dose of nitrogen mustard and omission of procarbazine and melphalan. t-AML/MDS developed in 24 patients, 15 following primary chemotherapy and nine after salvage chemotherapy for relapsed HL. G studies had a significantly lower incidence of t-AML/MDS (0.3%) compared with the S (5.7%) or C (5.2%) studies. No t-AML/MDS was seen in G studies after primary therapy. No patient from the G studies developed t-AML-MDS after primary therapy; t-AML/MDA developed in one patient from the G studies following second-line therapy."Our data demonstrate the relationship between the cumulative AA dose and t-AML/MDS," the authors write. "The prognosis for t-AML/MDS is dismal, and it is imperative that therapies minimize these risks."