11例恶性肿瘤继发性骨髓增生异常综合征病例分析

目的：分析恶性肿瘤继发骨髓增生异常综合征（MyelodysplasticSyndrome，MDS）病例资料，寻找肿瘤继发MDS关键致病因素，并为原发病治疗风险评估提供参考依据。方法：采用回顾性研究方法，查阅北京中医药大学东直门医院肿瘤血液科2007年1月．2012年4月MDS患者住院病例，区分原发、继发两种类型，并对继发性MDS病例资料进行综合分析。结果：按照MDS诊断标准，在明确诊断的75例患者中，原发性64例，肿瘤继发11例，占14．67％。11例患者均为中老年人群，其中，65岁以上老龄患者7例，占63．6％；70岁以上老龄患者5例，占45．45％。肿瘤继发MDS，尤其是老龄患者特征为严重合并症多，生存质量差，生存期短。致病原因有多方面因素，其中，放化疗联合应用可增加肿瘤继发MDS的风险性。结论：恶性肿瘤及其相关治疗易继发MDS，放化疗联合应用可增加其风险性；老龄患者继发MDS的机会明显增加，且预后不良。因此，对于老龄肿瘤患者要认真评估治疗受益和相关风险。

Analysis of 11 Cases with Secondary Myelodysplastic Syndrome after Treatment of Cancer

Objective： Myelodysplastic syndromes following treatment of cancer is called secondary myelodysplastic syndrome （MDS）. This research was to analyze the Clinical data of secondary MDS cases, so as to explore the critical pathogenic factors of MDS following treatment of cancer and to provide a reference for accessing the risks of the cancer therapy. Methods： A retrospective study was conducted to analyze the clinical data of MDS cases admitted in Dongzhimen Hospital affiliated to Beijing University of Chinese Medicine from January 2007 to April 2012. All the MDS cases were divided as the primary or secondary MDS, and the data of secondary MDS cases were comprehensively analyzed. Results： According to the diagnostic criteria for MDS, there were 75 patients diagnosed with MDS, including 64 patients with primary MDS, andl 1 patients with secondary MDS which accounted for 14.67%. All the 11 cases with secondary MDS were among the elderly population, while 7 patients were over the age of 65, accounting for 63.6%, and 5 patients were over the age of 70, accounting for 45.45%. Secondary MDS patients, especially the elderly patients were characterized by serious complications, poor quality of life, and short survival period. There are many pathogenic factors, while chemoradiotherapy could increase the risks of secondary MDS. Conclusion： Malignant tumors and related treatment may cause secondary MDS, and chemoradiotherapy can increase the risk, while the elderly had a higher incidence of secondary MDS with poor prognosis. The clinicians should be very seriously to evaluate treatment benefits and associated risks for elderly cancer patients with malignant tumors.