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铂类药物被广泛的用于多种癌症的化疗,特别对卵巢癌的疗效明显,但临床发现该类药物有诱发白血病的作用。本文报告了北美和欧洲地区28971例卵巢癌病人以铂类药物化疗后白血病发病情况的研究结果。 在28971例病人中共发生白血病96例,其中急性髓性白血病及骨髓增生异常综合征90例、急性淋巴细胞白血病3例、慢性髓性白血病3例;诊断卵巢癌时的年龄<50岁10例,50～59岁18例,60～69岁40例,≥70岁28例。卵巢癌Ⅰ～Ⅱ期40例,Ⅲ～Ⅳ期56例。卵巢癌治疗方法:单纯手术5例,单用放疗1例,铂类药物化疗65例,放疗联合铂类药物化疗25例。 结果显示:白血病的发生多在卵巢癌诊断后4年,其中94％的接受铂类药物或烷化剂治疗,此时74％的病人卵巢癌处于缓解期,发生白血病后的中位存活期为3个月。统计学分析发现,
Platinum drugs are widely used in a variety of cancer chemotherapy, especially for the efficacy of ovarian cancer, but the clinical findings of these drugs have the role of leukemia. This article reports the results of 28971 patients with ovarian cancer in North America and Europe treated with platinum-based chemotherapy for leukemia. There were 96 cases of leukemia in 28971 cases, including 90 cases of acute myelogenous leukemia and myelodysplastic syndrome, 3 cases of acute lymphoblastic leukemia and 3 cases of chronic myelogenous leukemia. 10 cases were diagnosed as ovarian cancer <50 years old, 18 cases were 50-59 years old, 40 cases were 60-69 years old and 28 cases were ≥70 years old. Ovarian cancer Ⅰ ~ Ⅱ 40 cases, Ⅲ ~ Ⅳ 56 cases. Ovarian cancer treatment: 5 cases of surgery alone, 1 case of radiotherapy alone, 65 cases of platinum-based chemotherapy, radiotherapy combined with platinum-based chemotherapy in 25 cases. The results showed that the incidence of leukemia in ovarian cancer more than 4 years after diagnosis, of which 94% received platinum drugs or alkylating agents, when 74% of patients with ovarian cancer in remission, the median survival after leukemia was 3 months. Statistical analysis found that,