Secondary acute promyelocytic leukemia following chemotherapy for gastric cancer: A case report

Therapy-related acute myeloid leukemia(t-AML) refers to a heterogeneous group of myeloid neoplasms that develop in patients following extensive exposure to either cytotoxic agents or radiation.The development of t-AML has been reported following treatment of cancers ranging from hematological malignancies to solid tumors; however, to our knowledge, t-AML has never been reported following treatment of gastric cancer.In this study, we report the development of t-acute promyelocytic leukemia in a cT 4N1M0 gastric cancer patient after an approximate 44 mo latency period following treatment with 4 cycles of oxaliplatin(OXP)(85 mg/m2 on day 1) plus capecitabine(1250 mg/m2 orally twice daily on days 1-14) in combination with recombinant human granulocyte-colony stimulating factor treatment.Karyotype analysis of the patient revealed 46,XY,t(15;17)(q22;q21)[15]/46,idem,-9,+add(9)(p22)[2]/46,XY[3], which, according to previous studies, includes some "favorable" genetic abnormalities.The patient was then treated with all-trans retinoic acid(ATRA, 25 mg/m2/d) plus arsenic trioxide(ATO, 10 mg/d) and attained complete remission.Our case illuminated the role of certain cytotoxic agents in the induction of t-AML following gastric cancer treatment.We recommend instituting a mandatory additional evaluation for patients undergoing these therapies in the future.

奥沙利铂加氟脲嘧啶持续静脉滴注治疗晚期食道癌

目的 观察奥沙利铂联合醛氢叶酸和氟脲嘧啶持续静脉滴注治疗晚期食道癌的疗效及不良反应。方法 经病理组织学诊断的晚期食道癌 35例 ,奥沙利铂 (Oxaliplatin ,L -OHP ,法国赛诺菲公司生产 ,商品名为乐沙定Eloxatin) 130mg/m2 静脉滴注 2h ,第 1天 ;醛氢叶酸 (LV) 2 0 0mg/m2 ,静脉滴注 2h ,随后氟脲嘧啶 (5 -Fu) 375mg/m2 静脉推注 10min ,再接 5 -Fu 3 0g/m2 用输液泵连续滴注 12 0h ,2 1天为 1周期。所有患者至少接受 2个周期的治疗。结果 35例均可评价疗效 ,总有效率 5 7 1%。初治病例 2 2例 ,有效率 6 3 6 %。复治病例 13例 ,有效率 4 6 2 %。主要不良反应为神经毒性 ,骨髓抑制 ,恶心 /呕吐 ,腹泻 ,粘膜炎等。无治疗相关死亡者。结论 L -OHP联合LV和 5 -Fu持续滴注治疗晚期食道癌患者 ,缓解率较高 ,毒性相对较低 。

PCF与FOLFOX4方案治疗进展期胃癌的临床观察

目的探讨PCF方案与FOLFOX4方案治疗进展期胃癌(AGC)的疗效及安全性。方法 94例AGC患者根据不同化疗方案分为两组。A组,49例,PCF方案:PTX 35～50mg/m2,3h静滴,第1、8、15天;5-FU 750mg/m2,持续静滴,第1～5天;DDP 20mg/m2,2h静滴,第1～5天。B组,45例,FOLFOX4方案:草酸铂85mg/m2,静脉滴注2h,第1天;亚叶酸钙200mg/m2,静滴2h,第1、2天;氟脲嘧啶400mg/m2,静注,第1、2天,氟脲嘧啶600mg/m2,持续静脉泵输注22h,第1、2天。每4周为1疗程,疗程后评判近期疗效、安全性,持续随访远期疗效。结果 A组总有效率(ORR)46.9%,疾病控制率(DCR)81.6%,中位生存期(MST)10.6个月,1年生存率35.0%;B组ORR 46.7%,DCR 82.2%,MST 9.8个月,1年生存率33.1%;两组近、远期疗效差异无统计学意义(P>0.05)。Ⅲ～Ⅳ度不良反应主要为中性粒细胞减少、恶心呕吐。A组脱发发生率高于B组,外周神经毒性低于B组(P<0.05)。结论 PCF方案与FOLFOX4方案治疗AGC,疗效和生存情况相似,不良反应均可耐受。