乙双吗啉/乙亚胺治疗银屑病与继发白血病关系的回顾性病例对照研究

Bimolane/ethylimine treatment and secondary leukemia in patients with psoriasis:a retrospective case-control study

目的:研究银屑病患者服用乙双吗啉/乙亚胺与继发白血病的关系。方法:根据入选标准收集1990年1月至2006年3月间住院的银屑病患者189例,其中合并白血病患者39例,为病例组(服用过乙双吗啉/乙亚胺的患者22例);未合并白血病患者150例,为对照组(服用过乙双吗啉/乙亚胺的患者19例)。对服药者与未服药者发生白血病的风险、白血病类型和染色体畸变率进行分析。结果:41例服药者中22例(53.66%)发生了白血病,148例未服药者中17例(11.49%)发生了白血病。服药者与未服药者的白血病发生风险的比值比(OR)为8.92(95%可信区间为3.76￣21.44,P<0.01)。染色体检查显示,服药者12例中,10例有染色体异常(83.33%),未服药者8例中有5例染色体异常(62.50%),二者染色体异常的发生率无统计学差异。继发白血病类型以急性早幼粒细胞性白血病(M3)为主要类型(53.85%),其次为急性粒细胞性白血病部分分化型(M2),占25.64%。结论:治疗银屑病时继发白血病可能与服用乙双吗啉/乙亚胺有关,白血病类型主要为粒细胞性白血病。

Objective： To investigate the relationship between bimolane/ethylimine treatment and secondary leukemia in patients with psoriasis. Methods： According to entry criteria, 189 patients hospitalized for psoriasis during the period fi＇om January 1990 to March 2006 were enrolled. Of the 189 patients, 39 patients with secondary leukemia entered into the case group （22 patients had received bimolane/ethylimine） and 150 patients without secondary leukemia entered into the control group （19 patients had received bimolane/ethylimine）. The odds ratio（OR） of secondary leukemia, type of leukemia, and chromosome aberration rate in the patients who had received or had not received biomolane/ethylimine treatment were analyzed. Results.. Of the 41 patients who had received bimolane/ethylimine treatment, 22 patients（53.66%） developed leukemia. And of the 148 patients who had not received bimolane/ethyline treatment, 17 patients（11.49%） developed leukemia （OR=8.92, 95% confidence interval=3.76-21.44, P〈0.01）. Chromosome examination revealed that 10（83.33%） of 12 patients who had received bimolane/ethylimine treatment had chromosome aberration and 5 （62.50%） of 8 patients who had not received bimolane/ethylimine treatment had chromosome aberration, the rate of chromosome aberration had no stastistically difference （P〉0.05）.Acute promyelocytic leukemia （M3） was the predominant type （53.85%） followed by acute granulocytic leakemia （M2） （25.64%）. Conclusion.. Secondary leukemia may be associated with bimolane/ethylimine used in the treatment for psoriasis. Granulooytic leukemia is the main form of leukemiainduced by bimolane/ethylimine.