Background: Small cell lung cancer (SCLC) is highly malignant and prone to bone marrow metastasis in early stage, but its related reports are limited. This study analyzed the clinical feature, laboratory examination, treatment and prognosis of SCLC patients with bone marrow metastasis.
Methods: The clinical data of 26 SCLC patients with bone marrow metastasis were analyzed retrospectively. Prognostic factors were evaluated.
Results: The median age of 26 patients was 57 years and the median time from diagnosis of SCLC to confirmed bone marrow metastases was 8 d. Most patients (96.2%) were accompanied by other organ metastases. The most common laboratory abnormalities were elevated lactate dehydrogenase in 19 cases (73.1%), thrombocytopenia and elevated alkaline phosphatase respectively in 11 cases (42.3%) and anemia in 7 cases (26.9%). Twenty patients had received chemotherapy and the remaining 6 patients had not. Of this group, 16 patients received at least 2 cycles of chemotherapy after the diagnosis of bone marrow metastasis. The median survival time was 15.7 wk (0.1 wk-82.9 wk) after diagnosis of bone marrow metastasis. The survival of patients with chemotherapy was significantly better than that of those without chemotherapy (χ²=33.768, P<0.001). Multivariate analysis showed that no chemotherapy was independent poor prognostic factors (P<0.05).
Conclusions: The SCLC patients with bone marrow metastasis have short survival, whereas chemotherapy can extend the survival of patients.
【中文题目：小细胞肺癌骨髓转移患者的临床分析】 【中文摘要：背景与目的 小细胞肺癌（small cell lung cancer, SCLC）恶性程度高，早期易发生骨髓转移，但其相关报道有限。本研究分析SCLC骨髓转移患者的临床表现，实验室检查、治疗以及预后。方法 回顾性分析26例SCLC骨髓转移患者的临床资料，分析其预后相关因素。结果 26例SCLC骨髓转移患者的中位年龄57岁，从诊断SCLC到确诊骨髓转移的中位时间为8天。多数患者（96.2%）同时伴有其他脏器转移。最常见的实验室异常为乳酸脱氢酶增高19例（73.1%），血小板减少和碱性磷酸酶增高各11例（42.3%），贫血7例（26.9%）。全组在诊断骨髓转移后，6例未化疗，20例化疗，其中16例至少接受了2个周期化疗。全组患者确诊骨髓转移后的中位生存期为15.7周（0.1周-82.9周），接受化疗患者的生存期显著优于未化疗者（χ²=33.768, P<0.001）。多因素分析显示未化疗是独立的预后不良的因素（P<0.05）。结论 SCLC骨髓转移患者的生存期短，化疗可延长患者的生存。 】 【中文关键词：肺肿瘤；小细胞癌；骨髓转移；预后】.
Keywords: Bone marrow metastases; Lung neoplasmas; Prognosis; Small cell cancer.