近年来实体瘤治疗相关血液肿瘤的发病率呈增长趋势,相比原发血液肿瘤,治疗相关血液肿瘤的预后更差,是实体瘤治疗后最严重的并发症之一.潜能未定的克隆性造血(clonal haematopoiesis of indeterminate potential,CHIP)已被认为是治疗相关髓系肿瘤(therapy-related myeloid neoplasm,t-MN)发病机制中的相关因素,通过促进驱动基因突变导致 t-MN风险增加.治疗相关性血液肿瘤的发病主要与烷化剂、拓扑异构酶抑制剂、铂类化合物、PARP抑制剂及放射治疗有关.目前,同种异体造血干细胞移植仍然是治疗相关血液肿瘤的最佳治疗方案.本综述旨在分析T-MN的流行病学、发病机制、相关药物、预后及治疗等方面的进展.
Abstract
In recent years,the number of diagnosed therapy-related hematological neoplasms has increased.Compared to primary hemato-logical neoplasms,therapy-related hematological neoplasms have a poorer prognosis and are a serious complication following the treat-ment of solid tumors.Clonal hematopoiesis of indeterminate potential(CHIP)is considered a relevant factor in the pathogenesis of therapy-related myeloid neoplasms(t-MNs),leading to an increased risk of t-MN by promoting driver gene mutations.The pathogenesis of therapy-related hematological neoplasms primarily involves alkylating agents,topoisomerase inhibitors,platinum agents,poly ADP-ribose poly-merase(PARP)inhibitors,and radiotherapy.Currently,allogeneic stem cell transplantation remains the most effective therapeutic option.This review analyzes advances in the epidemiology,pathogenesis,related drugs,prognosis,and treatment of therapy-related hematological neoplasms.
维普
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