非霍奇金淋巴瘤继发第二肿瘤54例临床分析

Clinical Analysis of Non-Hodgkin's Lymphoma Associated with Secondary Malignant Neoplasm

目的:探讨非霍奇金淋巴瘤(NHL)患者继发第二肿瘤的临床特点、风险评估及预后分析方法:收集我院2000～2010年间1 839例NHL患者临床资料,从中检索继发第二肿瘤的病例并分析继发肿瘤的相关风险及预后因素。结果:54例NHL患者在治疗后1～10年发生了第二种肿瘤,其中白血病19例,肺癌9例,结直肠癌9例,乳腺癌3例。多因素分析显示,初治年龄大于45岁的NHL患者发生各种继发肿瘤的风险更高。8周期以上的化疗仅增加白血病发生的风险、NHL的AnnArbor分期是继发肿瘤患者的独立预后因素,同时与继发第二肿瘤的潜伏时间相关。结论:初治年龄大于45岁以及接受8周期以上的化疗是继发肿瘤的危险因素。AnnArbor分期较晚的NHL继发肿瘤潜伏时间和生存时间均较短。

Objective： To understand the clinical characteristics and prognostic factors of patients with secondary mahgnant neo plasm （SMN） following NonHodgkin＇s lymphoma （NHL）. Methods： Clinical data of patients with SMN after they were treated for NHL in our department from 2001 to 2010 were collected and analyzed. Results： Fiftyfour SMN cases （35 males and 19 females） were observed. Multivariate regression analyses showed that patients 〉45 years old had higher risk of secondary cancer. Those who received more than eight cycles of chemotherapy had increased risk of leukemia. The Ann Arbor stage of NHL is not only an independent prog nostic factor of SMN, but it also has significant independent impacts on the time independence of secondary tumors. Conclusion： The recognition of SMN should be enhanced, and the screening for it in a highrisk population should be performed. The overuse of therapy to improve the patient＇s condition should also be avoided.