Objective: To investigate the clinical characteristics and prognosis of hematological malignancies superimposed patients with solid tumors.
Methods: The clinical data of 30 patients with more than two kinds of malignancy (the second is hematological malignancy) from October 2011 to October 2020 in Department of Hematology, Jiangning Hospital Affiliated to Nanjing Medical University were collected and analyzed retrospectively. The overall survival time was used as the prognostic evaluation standard, and the survival of patients were analyzed by KaplanMeier method. Logrank test and Cox regression model were used to carry out univariate and multivariate retrospective analysis on clinical and laboratory parameters of 30 patients.
Results: Among 30 cases, 20 were male, 10 were female, the median age of onset of the second tumor was 70 years old. The common types of the secondary hematological malignancies to solid tumors are myelodysplastic syndrome, acute myeloid leukemia, multiple myeloma. Univariate analysis showed that patients' gender, age, type of solid tumors, the onset of interval between two kinds of tumor, chromosome karyotype were not related to do with the patients' overall survival time. Type of hematologic disease, ECOG score were associated with patients' overall survival time, and the multivariate analysis showed that the type of hematologic disease and ECOG score were independent risk factors for patients with poor prognosis.
Conclusion: Patients superimposed with solid tumors complicated with myelodysplastic syndrome or acute leukemia and ECOG score ≥3 have poor prognosis and shorter overall survival time, which are independent risk factors influencing the prognosis. Bone marrow injury, immune dysfunction and genetic susceptibility after chemoradiotherapy may be the main causes of these diseases.
题目: 迭合于实体肿瘤的恶性血液病患者的临床特征及预后分析.
目的: 探讨迭合于实体肿瘤的恶性血液病患者的临床特点及预后特征.
方法: 收集南京医科大学附属江宁医院血液科自2011年10月至2020年10月接诊的30例迭合于实体肿瘤的恶性血液病（恶性血液病为第二肿瘤）患者的临床资料，对其进行回顾性分析。以总生存时间（OS）作为预后评价标准，采用KaplanMeier法进行生存分析。采用Logrank检验对几种预后相关影响因素进行单因素分析，采用Cox回归模型进行多因素分析.
结果: 30例患者中，男性20例，女性10例，血液肿瘤中位发病年龄为70岁，常见类型为骨髓增生异常综合征、急性髓系白血病及多发性骨髓瘤。单因素分析显示，患者性别、年龄、实体肿瘤类型、两种肿瘤之间发病间隔、染色体核型等与患者总生存时间无关，而血液肿瘤类型、ECOG评分与患者总生存时间相关；多因素分析显示，血液肿瘤类型和ECOG评分为患者预后不良的独立危险因素.
结论: 迭合于实体肿瘤的骨髓增生异常综合征及急性白血病、ECOG评分≥3分的患者预后较差，总生存时间较短。患者自身遗传易感性、放化疗后骨髓损伤、免疫功能紊乱可能为此类疾病发病的主要原因.
Keywords: ECOG score; hematological disease; solid tumor; superimposed with.