摘要目的 探讨治疗相关血液肿瘤的临床特征及预后.方法 采用细胞形态学、流式细胞术、间接荧光原位杂交技术(I-FISH)、染色体核型分析对35例治疗相关血液肿瘤患者进行诊断和分型并回顾性分析其临床特征及预后.结果 35例患者中,治疗相关急性髓系白血病(t-AML)20例,治疗相关急性淋巴细胞白血病(t-ALL)4例,治疗相关急性混合细胞白血病1例,治疗相关非霍奇金淋巴瘤(t-NHL)8例,治疗相关骨髓增生异常综合征(t-MDS)2例.第一肿瘤至治疗相关恶性血液肿瘤的中位发病间隔期为29(16～90)个月,中位生存时间14(1～60)个月,3年累积生存率为17.1％.在25例治疗相关性急性白血病患者中,40.0％(10/25)合并复杂核型,36.0％ (9/25)合并MLL断裂基因重排,12.0％(3/25)合并AML-ETO融合基因阳性,1例合并NPM1点突变,1例合并P16基因缺失.结论 治疗相关血液肿瘤患者的预后较差.

abstractsObjective To investigate the morbidity,treatment outcomes and prognosis of 35 therapy-related hematological neoplasms patients.Methods A total of 35 cases of therapy-related hematological neoplasms were examined genetically and immunologically using flow cytometry,karyotype analysis and FISH,and their clinical data were retrospective analyzed and literatures were reviewed.Results Among 35 patients,there were 20 cases of therapy-related acute myeloid leukemia (t-AML),4 cases of therapy-related acute lymphoblastic leukemia (t-ALL),1 case of acute mixed leukemia,therapyrelated non-hodgkin's lymphoma (t-NHL) in 8 cases and myelodysplastic syndrome (t-MDS) in 2 cases.The median onset of t-HN was 29(16-90) months,the median OS of t-HN was 14(1-60) months,and 3 years of OS was 17.1％.Among therapy-related acute leukemia (t-AL) patients,40％ (10/25) patients had combined complex karyotype,36％ (9/25) patients with MLL gene rearrangement,12％ (3/25) patients with combined AML/ETO fusion gene,1 case with NPM1 point mutation and 1 case with P16 gene deletion.Conclusions Therapy-related hematological neoplasms had a worse prognosis.