自家末梢血幹細胞移植後に発症した二次性固形癌症例の検討  [in Japanese] Secondary solid tumors in autologous-peripheral blood stem cell transplantation recipients  [in Japanese]

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Author(s)

Abstract

自家末梢血幹細胞移植(PBSCT)施行後6カ月以上経過観察された109例(急性骨髄性白血病18例,急性リンパ性白血病7例,非Hodgkinリンパ腫52例,Hodgkin病5例,多発性骨髄腫16例,慢性骨髄性白血病1例,骨髄異形成症候群3例,固形腫瘍7例)において,二次性固形癌の発生頻度の検討を行った。移植後14∼43カ月で,4例に二次性固形癌の発生が見られた(肺の大細胞癌,直腸の腺癌,肝臓の胆管細胞癌,口腔底の扁平上皮癌と胆嚢の腺癌)。基礎疾患別では非Hodgkinリンパ腫52例中3例に,多発性骨髄腫16例中1例に見られた。年齢別では,移植時の年齢が50歳台であった31例中1例に,60歳台であった31例中3例に二次性固形癌が発生した。二次性固形癌の累積発生率はKaplan-Meier法で算定すると,8年間で8%であった。auto-PBSCTでは移植後の二次性固形腫瘍の発生率が高く,特に60歳以上の症例では注意して経過観察する必要がある。

We investigated the incidence of post-transplant solid tumors in a cohort of 109 patients who had undergone auto-peripheral blood stem cell transplantation (PBSCT) for acute myelogenous leukemia (n=18), acute lymphoblastic leukemia (n=7), non-Hodgkin's lymphoma (n=52), Hodgkin's disease (n=5), multiple myeloma (n=16), chronic myelogenous leukemia (n=1), myelodysplastic syndrome (n=3) and solid tumors (n=7). The patients were followed up for a median of 32 months after PBSCT. Five second solid malignancies developed in 4 patients within 14 to 43 months after PBSCT: large cell carcinoma of the lung, adenocarcinoma of the rectum, cholangiocellular carcinoma of the liver, squamous cell carcinoma of the mouth, and adenocarcinoma of the gallbladder. The affected patients were 3 of 52 with non-Hodgkin's lymphoma and one of 16 with multiple myeloma. One of the patients was in the 5th decade of life (n=31) and 3 were in the 6th decade (n=31). The cumulative actuarial risk for developing post-transplant solid tumors was 8% at 8 years. Elderly patients (≥60 year old) who have undergone PBSCT need to be observed carefully for second neoplasms because of their increased risk of post-transplant solid tumors.

Journal

  • Rinsho Ketsueki

    Rinsho Ketsueki 41(8), 621-627, 2000-08-30

    The Japanese Society of Hematology

References:  15

Codes

  • NII Article ID (NAID)
    10008038002
  • NII NACSIS-CAT ID (NCID)
    AN00252940
  • Text Lang
    JPN
  • Article Type
    ART
  • ISSN
    04851439
  • NDL Article ID
    6295687
  • NDL Source Classification
    ZS21(科学技術--医学--内科学)
  • NDL Call No.
    Z19-295
  • Data Source
    CJP  NDL  J-STAGE 
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