血液肿瘤患者中多种恶性肿瘤发生风险及生存分析:2009年至2017年单中心回顾性研究

The Risk and Survival Analysis of Multiple Malignancies in Hematologic Malignancy Patients:A Single Chinese Center Retrospective Study,2009 through 2017

目的:探讨江苏省人民医院随访9年的血液肿瘤患者中多种恶性肿瘤发生的风险及部位,并评估第二原发恶性肿瘤对患者生存的影响。方法:回顾性分析2009-2017年7921例血液肿瘤患者多种恶性肿瘤的发病率及其生存情况。结果:在7921例血液肿瘤患者中共有180例(2.3%)患者发生第二恶性肿瘤,其中58例患者血液肿瘤被诊断为第一原发恶性肿瘤,98例患者血液肿瘤被诊断为第二原发恶性肿瘤,另外24例患者在第一原发恶性肿瘤发病后6个月内确诊第二恶性肿瘤,被定义为同时发生的多种原发恶性肿瘤。在180例多发恶性肿瘤患者中,18例患者先后发生2种血液肿瘤,11例患者发生3种以上恶性肿瘤(其中2名女性患者被诊断出患有4种恶性肿瘤)。淋巴瘤和多发性骨髓瘤作为第二原发恶性肿瘤的患者较淋巴瘤和多发性骨髓瘤作为第一原发恶性肿瘤患者的生存差。慢性粒细胞白血病作为第二原发恶性肿瘤也与较低的总生存相关。结论:本研究的血液肿瘤患者中2.3%合并多种恶性肿瘤,淋巴瘤、MM作为第二原发恶性肿瘤的患者预后差。

Objective:To explore the risk and location of multiple malignancies in patients with hematologic malignancies who were followed up for 9 years in Jiangsu Province Hospital and to evaluate the impact of the second primary malignancy on survival of patients.Methods:The incidence and survival of multiple malignancies in 7921 patients with hematologic malignancies from 2009 to 2017 were analyzed retrospectively.Results:A total of 180(2.3%,180/7921)patients developed second malignancy,of whom 58 patients were diagnosed with hematologic malignancies as the first primary malignancy,and 98 patients developed hematologic malignancies as second primary malignancy,and the other 24 cases were diagnosed with the second malignancy within 6 months after the first primary malignancy was diagnosed,which was difined as multiple malignancies occurring simultaneously.In 180 patients,18 cases developed two hematologic malignancies successively,and 11 patients developed more than 3 primary cancers(among them,2 female patients were diagnosed with 4 primary cancers).Patients with lymphoma and multiple myeloma(MM)as the second primary malignancy had poorer survival than patients with lymphoma and MM as the first primary malignancy.Patients with chronic myeloid leukemia as the second primary malignancy were also associated with inferior overall survival.Conclusion:In this study,2.3%of hematologic malignancy patients had multiple malignancies,lymphoma and MM as the second primary malignancy had poor survival.