PDF(Pubmed)
Abstract：
Concern has emerged about the prevalence of second cancers among patients with hairy cell leukemia (HCL) treated with purine analogs. We investigated 513 patients with HCL treated with cladribine over the last 30 years at 18 Italian centers and calculated their standardized incidence ratios (SIRs). We identified 24 patients with a second cancer diagnosed at a median time from treatment with cladribine of 59.9 months (range: 9.2-169.7 months). All patients with solid neoplasms presented with a limited-stage disease, except four cases of locally advanced cancer; multiple myeloma patients had a smoldering disease, while lymphoma patients had stage Ie and stage IV diseases. Response to therapy was complete in 19 cases; 1 patient is still receiving treatment for a relapsing bladder disease, while 2 patients progressed during treatment and died. These two patients died from unrelated causes: one from infection and one due to surgery complications. The median OS from HCL was 98.5 months (range: 38.4-409.2 months), while the median OS from second cancer was 27.6 months (range: 1-117.8 months). The SIR was 0.86 (95% CI: 0.54-1.30) for males and 1.13 (95% CI: 0.36-2.73) for females: no statistically significant differences were highlighted. We were not able to demonstrate an excess of second cancer or a significant association with the specific studied neoplasm.
摘要：
人们对嘌呤类似物治疗的毛细胞白血病（HCL）患者中第二癌症的患病率感到担忧。我们调查了过去30年中在18个意大利中心接受克拉屈滨治疗的513例HCL患者，并计算了其标准化发生率（SIR）。我们确定了24例诊断为第二次癌症的患者，中位时间为克拉屈滨治疗59.9个月（范围：9.2-169.7个月）。所有实体瘤患者均表现为局限期疾病，除了四例局部晚期癌症；多发性骨髓瘤患者有闷烧的疾病，而淋巴瘤患者患有Ie期和IV期疾病。19例患者对治疗反应完全；1例患者仍在接受复发性膀胱疾病的治疗，而2例患者在治疗期间进展并死亡。这两名患者死于无关的原因：一个是感染，一个是手术并发症。HCL的中位OS为98.5个月（范围：38.4-409.2个月），而第二次癌症的中位OS为27.6个月（范围：1-117.8个月）。男性的SIR为0.86（95％CI：0.54-1.30），女性为1.13（95％CI：0.36-2.73）：没有突出的统计学差异。我们无法证明第二癌症的过量或与特定研究肿瘤的显着关联。
