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荷兰国立癌症研究所回顾性分析了1966-1983 年间收治的744例何杰金病患者。其中继发白血病16例,骨髓增殖异常综合征(MDS)6例,非何杰金淋巴瘤9例,实体瘤33例。作者用Cox模型分析了4类不同强度化疗、放疗对于继发白血病和MDS的危险性,发现性别和放疗对白血病或MDS的发生无明显影响,而强化疗、年龄和脾切除则有显著关系,见表1。脾切除患者继发白血病/MDS的危险性要高出3.6倍。38例大于40岁患者接受脾切除和强化化疗的,10年内继发白(?)/MDS的保险统计危险度(actuarial risk)为62%,未发现脾切除和继发其它恶性
The Netherlands National Cancer Institute retrospectively analyzed 744 Hodgkin’s patients who were treated between 1966 and 1983. Including leukemia in 16 cases, 6 cases of myelodysplastic syndrome (MDS), non-Hodgkin’s lymphoma in 9 cases, 33 cases of solid tumors. Using the Cox model, we analyzed the risk of four types of chemotherapy and radiotherapy for secondary leukemia and MDS. We found no significant effect of genital and radiotherapy on the occurrence of leukemia or MDS, but there was a significant relationship between intensive chemotherapy, age and splenectomy. See Table 1. Patients with splenectomy secondary leukemia / MDS risk 3.6 times higher. In 38 patients older than 40 years of age who underwent splenectomy and intensive chemotherapy, the actuarial risk for follow-up white / MDS was 62% within 10 years and splenectomy and secondary malignancy were not found