药物与白血病

Drug and Leukemia

近年来发现 ,抗肿瘤药物和非抗肿瘤药物 ,如烷化剂、拓扑异构酶Ⅱ抑制剂 ,及氯霉素和卡马西平等 ,可以引起治疗相关性白血病。这些治疗相关性白血病在细胞遗传学及细胞分子生物学方面表现不完全相同 ,各有特点。烷化剂治疗后常伴有第 5和第 7号染色体缺失和部分缺失( 5 /5q , 7/7q ) ;拓扑异构酶Ⅱ抑制剂治疗者常伴有基因重排或移位 ,如 11q2 3 (MLL基因 )异常 ,2 1q2 3 (AML1基因 )移位和t(15 ;17) ;非抗肿瘤药物引起白血病少见。药物治疗相关性白血病与药物作用机制、药物累积剂量和初发疾病有直接关系 ,多数患者治疗再缓解率低 ,预后不良。

Some anti-cancer or non-anti-cancer drugs have been considered in relation to leukemogenesis.Chmotherapy drugs,such as alkylating agents and topoisomerase II inhibitors,are the most risk factors;and chloramphenicol and karbamazpine were considered to induce leukemia,but lack of direct evidence.Alkylating agents treated shown unbalanced chromosome aberrations,such as chromosome deletion or loss of 7q or monosomy 7 and 5q or monosomy 5,and others.Topoisomerase II inhibitors can cause balanced translocation or rearrangement.The drug-related leukemia is directly related to the drugs mechanism and cumulative doses , and primary malignancies.