治疗相关的骨髓增生异常综合征病例报道并 文献复习

Treatment-Related Myelodysplastic Syndromes: Case Reports and Literature Review

摘要: 目的：提高对治疗相关的髓系肿瘤患者并发恶性贫血的认识，及时正确的诊断，以降低误诊、漏诊率。方法：回顾性分析我院肿瘤科就诊的因小细胞肺癌治疗后导致的长期贫血的病人临床资料，并进行相关文献复习。结果：患者，男，68岁，以小细胞肺癌治疗后导致的贫血为首要临床表现，后通过外周血涂片、骨髓形态、铁染色体等检查，最终确诊为治疗相关的骨髓增生异常综合征。结论：治疗相关的髓系肿瘤是一组克隆性血液病，主要是某些细胞毒性治疗或放射治疗后在造血干细胞和祖细胞中诱导的获得性体细胞突变、染色体畸变等导致的血液系统肿瘤，我们需要结合患者的病史、血常规、骨髓形态学、细胞化学染色、分子生物学、遗传学等综合诊断分析，及早的发现血液病患者，并对其尽早干预，以改善患者的预后，提高患者的生存质量。

Abstract: Objective: To enhance the understanding of treatment-related myeloid neoplasms in patients with concurrent malignant anemia, and to achieve timely and accurate diagnosis to reduce the rates of misdiagnosis and missed diagnosis. Methods: A retrospective analysis was conducted on the clinical data of patients with long-term anemia caused by small cell lung cancer treatment in the oncology department of our hospital, and relevant literature was reviewed. Results: The patient was a 68-year-old male, presenting with anemia as the primary clinical manifestation after treatment for small cell lung cancer. Through peripheral blood smear, bone marrow morphology, and iron staining, he was ultimately diagnosed with treatment-related myelodysplastic syndrome. Conclusion: Treatment-related myeloid neoplasms are a group of clonal hematological disorders, mainly caused by acquired somatic mutations and chromosomal aberrations induced in hematopoietic stem cells and progenitor cells after certain cytotoxic treatments or radiotherapy. We need to conduct a comprehensive diagnostic analysis based on the patient’s medical history, blood routine, bone marrow morphology, cytochemical staining, molecular biology, and genetics to detect hematological diseases early and intervene as soon as possible to improve the prognosis and quality of life of patients.