目的:治疗相关的骨髓性肿瘤(t-MNs)通常是致命的,并且是以前抗癌药物治疗的晚期并发症。没有单中心病例系列检查了上皮性卵巢癌(EOC)中的t-MNs。
方法:纳入2000年至2021年在千叶大学医院接受治疗的所有EOC患者。我们回顾性分析了这些特征,临床课程,以及发展为t-MNs的患者的结局。
结果:在895例EOC患者中,814例接受抗癌药物治疗。中位随访期为45个月(四分位距,27-81)个月。10例患者(1.2%)发展为t-MNs(1例FIGOIIIA,三,IIIC,IVA合二为一,和IVB在五个)。9例患者被诊断为骨髓增生异常综合征和1例急性白血病。一名骨髓增生异常综合征患者发展为急性白血病。从首次化疗到t-MN发病的中位时间为42个月(范围,21-94个月),4例全血细胞减少症导致t-MN诊断,三血小板减少症,和胚细胞或异常细胞形态四。以前的治疗方案的中位数为四个(范围,1-7).所有患者均接受紫杉醇+卡铂治疗,吉西他滨和伊立替康联合治疗9,贝伐单抗到8,奥拉帕利增加到4。6例患者接受t-MN化疗。所有患者死亡(8例癌症相关死亡和2例t-MN相关死亡)。没有一个患者能够重新开始癌症治疗。t-MN发病的中位生存时间为4个月。
结论:发生t-MN的EOC患者无法重新开始癌症治疗,预后明显较差。
OBJECTIVE: Therapy-related myeloid neoplasms (t-MNs) are often fatal and arise as late complications of previous anticancer drug treatment. No single-center
case series has examined t-MNs in epithelial ovarian cancer (EOC).
METHODS: All patients with EOC treated at Chiba University Hospital between 2000 and 2021 were included. We retrospectively analyzed the characteristics, clinical course, and outcomes of patients who developed t-MNs.
RESULTS: Among 895 cases with EOC, 814 cases were treated with anticancer drugs. The median follow-up period was 45 months (interquartile range, 27-81) months. Ten patients (1.2%) developed t-MNs (FIGO IIIA in one
case, IIIC in three, IVA in one, and IVB in five). Nine patients were diagnosed with myelodysplastic syndrome and one with acute leukemia. One patient with myelodysplastic syndrome developed acute leukemia. The median time from the first chemotherapy administration to t-MN onset was 42 months (range, 21-94 months), with t-MN diagnoses resulting from pancytopenia in four cases, thrombocytopenia in three, and blast or abnormal cell morphology in four. The median number of previous treatment regimens was four (range, 1-7). Paclitaxel + carboplatin therapy was administered to all patients, gemcitabine and irinotecan combination therapy to nine, bevacizumab to eight, and olaparib to four. Six patients received chemotherapy for t-MN. All patients died (eight cancer-related deaths and two t-MN-related deaths). None of the patients was able to restart cancer treatment. The median survival time from t-MN onset was 4 months.
CONCLUSIONS: Patients with EOC who developed t-MN were unable to restart cancer treatment and had a significantly worse prognosis.