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目的:探讨非霍奇金淋巴瘤(NHL)患者继发第二肿瘤的临床特点、风险评估及预后分析方法:收集我院2000～2010年间1 839例NHL患者临床资料,从中检索继发第二肿瘤的病例并分析继发肿瘤的相关风险及预后因素。结果:54例NHL患者在治疗后1～10年发生了第二种肿瘤,其中白血病19例,肺癌9例,结直肠癌9例,乳腺癌3例。多因素分析显示,初治年龄大于45岁的NHL患者发生各种继发肿瘤的风险更高。8周期以上的化疗仅增加白血病发生的风险、NHL的AnnArbor分期是继发肿瘤患者的独立预后因素,同时与继发第二肿瘤的潜伏时间相关。结论:初治年龄大于45岁以及接受8周期以上的化疗是继发肿瘤的危险因素。AnnArbor分期较晚的NHL继发肿瘤潜伏时间和生存时间均较短。
Objective: To investigate the clinical characteristics, risk assessment and prognosis analysis of secondary tumor in patients with non-Hodgkin’s lymphoma (NHL). Methods: The clinical data of 1839 NHL patients from 2000 to 2010 in our hospital were collected, Tumor cases and analyze the associated risk of secondary tumors and prognostic factors. Results: A total of 54 NHL patients developed a second tumor 1 to 10 years after treatment, including 19 leukemia patients, 9 lung cancer patients, 9 colorectal cancer patients and 3 breast cancer patients. In multivariate analysis, NHL patients older than 45 years had a higher risk of developing secondary tumors. Chemotherapy over 8 cycles only increased the risk of leukemia. The Ann Arbor staging of NHL was an independent prognostic factor in patients with secondary tumors and was associated with latency to secondary second tumors. Conclusions: The initial treatment of patients older than 45 years and receiving more than 8 cycles of chemotherapy is a risk factor for secondary tumors. NHL secondary to late AnnArbor tumors had shorter latency and longer survival time.