酪氨酸激酶抑制剂（TKI）治疗期间发生的费城阴性细胞（CCA/Ph-）的大多数克隆细胞遗传学异常是短暂的，继发性骨髓增生异常综合征（MDS）/急性髓系白血病（AML）的发展很少见，但是日本患者的频率和临床意义仍然未知。我们在此报告了四名在TKI治疗期间发展为CCA/Ph并被诊断为继发性MDS/AML的患者。从TKI治疗开始到MDS/AML发作的持续时间为3到48个月，生存期为5~84个月。CCA/Ph-伴MDS/AML的发生可能与不良预后相关,建议对接受TKI治疗的患者进行仔细的随访.
Most clonal cytogenetic abnormalities of Philadelphia-negative cells (CCA/Ph-) occurring during tyrosine kinase inhibitor (TKI) treatment are transient, and the development of secondary myelodysplastic syndrome (MDS)/acute myeloid leukemia (AML) is rare, but the frequency and clinical significance in Japanese patients are still unknown. We herein report four patients who developed CCA/Ph- during TKI therapy and were diagnosed with secondary MDS/AML. The duration from TKI therapy initiation to MDS/AML onset ranged from 3 to 48 months, and the survival ranged from 5 to 84 months. The occurrence of CCA/Ph- with MDS/AML may be associated with a poor prognosis, and careful follow-up is recommended for patients who receive TKI therapy.
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