在儿童血液恶性瘤的幸存者中发生的二次瘤 - - 系统性审查
Ioana-Alexandra Horneț1, Andreea Bianca Stoica2, Dora Mihaela Cîmpian3
1Doctoral School of Medicine, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, Gheorghe Marinescu Street No. 38, 540136 Târgu Mureș, Romania.
Children (Basel, Switzerland)
|February 27, 2026
概括
儿童血液癌症的幸存者面临着明显增加的二次恶性瘤 (SMNs) 的风险. 终身监测至关重要,具体风险与治疗暴露和遗传因素有关.
科学领域:
- 儿科瘤学 儿科瘤学
- 癌症生存率研究 癌症生存率研究
- 晚期影响的流行病学.
背景情况:
- 儿童癌症占所有恶性瘤的一小部分,但幸存者面临长期风险.
- 二次性恶性瘤 (SMNs) 是儿童癌症幸存者的严重,危及生命的晚期影响.
- 血液癌症占儿童恶性瘤的很大一部分,幸存者有SMN终身风险.
研究的目的:
- 系统地审查儿童血液癌症幸存者的二次恶性瘤 (SMN) 的发生率和危险因素.
- 为长期癌症幸存者的监测策略提供信息.
- 为了确定特定的患者群体和与更高的SMN风险相关的暴露.
主要方法:
- 对队列和注册表研究进行PRISMA 2020一致的系统审查.
- 在主要数据库 (PubMed,Embase,科学网,Scopus,Cochrane图书馆) 进行搜索.
- 由两名审稿人进行的独立数据提取和偏差风险评估 (纽卡斯尔-太华尺度).
主要成果:
- 分析了43项涉及超过7万名幸存者的研究,随访时间中位数为5-30+年.
- 与普通人口相比,幸存者患SMN的发病率高出2.0至6.0倍 (AER为每10,000人年10-40).
- 与治疗相关的急性髓性白血病在5-10年内出现;固体瘤 (乳腺,甲状腺,中枢神经系统,瘤) 在治疗后10-25年出现. 在接受放射治疗和干细胞移植的女性霍奇金淋巴瘤幸存者中,发现风险最高.
结论:
- 二次性恶性瘤 (SMNs) 是儿童血液癌症治疗的可预测的晚期影响.
- 对幸存者来说,终身的,与暴露相关的监测是必不可少的.
- 未来的查应该整合治疗细节,移植条件和对精确的幸存者护理的遗传倾向.
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