bloodjourГематология и трансфузиологияRussian journal of hematology and transfusiology0234-57302411-3042ООО Издательский дом «Практика»10.35754/0234-5730-2025-70-1-97-113bloodjour-611Research ArticleКЛИНИЧЕСКИЕ НАБЛЮДЕНИЯCASE REPORTSОстрые миелоидные лейкозы и миелодиспластические синдромы, ассоциированные с предшествующей цитотоксической терапией. Характерные черты, прогноз и подходы к лечениюAcute myeloid leukemias and myelodysplastic syndromes associated with previous cytotoxic therapy. Characteristic features, prognosis, and treatment approacheshttps://orcid.org/0000-0002-1469-2365ВалиевТ. Г.ValievT. T.

Валиев Тимур Теймуразович, доктор медицинских наук, заведующий отделением детской онкологии и гематологии (химиотерапии гемобластозов) № 1

115478, г. Москва

Timur T. Valiev, Dr. Sci. (Med.), Head of the Department of Pediatric Oncology and Hematology (Chemotherapy of Hemoblastosis) No1

115478, Moscow

timurvaliev@mail.ruhttps://orcid.org/0000-0003-3244-7774ШиринА. Д.ShirinA. D.

Ширин Антон Дмитриевич, кандидат медицинских наук, гематолог, медицинский советник

127410, г. Москва

Anton D. Shirin, Cand. Sci. (Med.), hematologist, Medical Adviser

127410, Moscow

shirin-anton@mail.ruhttps://orcid.org/0000-0003-0261-5941КохноА. В.KokhnoA. V.

Кохно Алина Владимировна, кандидат медицинских наук, начальник отдела диагностики и лечения гематологических заболеваний 

125167, г. Москва

Alina V. Kokhno, Cand. Sci. (Med.), Head of the Department of Diagnostics and Treatment of Hematological Diseases

125167, Moscow

kohno@blood.ruhttps://orcid.org/0000-0002-1731-8336АнтиповаА. С.AntipovaA. S.

Антипова Алина Сергеевна, кандидат медицинских наук, онколог отделения противоопухолевой лекарственной терапии и гематологии отдела гематологии и трансплантации костного мозга

115478, г. Москва

Alina S. Antipova, Cand. Sci. (Med.), Oncologist of Department of Antitumor Drug Therapy and Hematology, Department of Hematology and Bone Marrow Transplantation

115478, Moscow

alina.antipova.dr@incloud.comhttps://orcid.org/0000-0002-0202-8176БарановаО. Ю.BaranovaO. Yu.

Баранова Ольга Юрьевна, кандидат медицинских наук, старший научный сотрудник отделения противоопухолевой лекарственной терапии и гематологии отдела гематологии и трансплантации костного мозга

115478, г. Москва

Olga Yu. Baranova, Cand. Sci. (Med.), Senior Researcher of Department of Antitumor Drug Therapy and Hematology, Department of Hematology and Bone Marrow Transplantation

115478, Moscow

baranova-crc@mail.ruhttps://orcid.org/0000-0001-9127-0257ФренкельМ. А.FrenkelM. A.

Френкель Марина Абрамовна, доктор медицинских наук, ведущий научный сотрудник лаборатории иммунологии гемопоэза

 115478, г. Москва

Marina A. Frenkel, Dr. Sci. (Med.), Leading Scientifi c Employee of Haematopoiesis Immunology Laboratory

115478, Moscow

marinafren@yandex.ruhttps://orcid.org/0000-0002-9400-7347ПалладинаА. Д.PalladinaA. D.

Палладина Александра Дмитриевна, кандидат медицинских наук, врач клинической лабораторной диагностики лаборатории клинической иммунологии и инновационных технологий консультативно-диагностического центра

115478, г. Москва

Alexandra D. Palladina, Cand. Sci. (Med.), Clinical Laboratory Diagnostics Doctor of Laboratory of Clinical Immunology and Innovative Technologies, Consultative and Diagnostic Center

115478, Moscow

alexandra.93@mail.ruhttps://orcid.org/0000-0002-9921-5620СенченкоМ. А.SenchenkoM. A.

Сенченко Мария Анатольевна, кандидат медицинских наук, патологоанатом патолого-анатомического отделения консультативно-диагностического центра

115478, г. Москва

Maria A. Senchenko, Cand. Sci. (Med.), Pathologist of Pathological Anatomy Department, Consultative and Diagnostic Center

115478, Moscow

senchenko.mariia@yandex.ruНаучно-исследовательский институт детской онкологии и гематологии ФГБУ «Национальный медицинский исследовательский центр онкологии им. Н.Н. Блохина» Министерства здравоохранения Российской ФедерацииРоссияPediatric Oncology and Hematology Institute, N.N. Blokhin Russian Cancer Research CenterRussian FederationООО «ЛЕОВИТ нутрио»РоссияLLC “LEOVIT nutria”Russian FederationФГБУ «Национальный медицинский исследовательский центр гематологии» Министерства здравоохранения Российской ФедерацииРоссияNational Medical Research Center for HematologyRussian FederationНаучно-исследовательский институт клинической онкологии ФГБУ «Национальный медицинский исследовательский центр онкологии им. Н.Н. Блохина» Министерства здравоохранения Российской ФедерацииРоссияResearch Institute of Clinical Oncology, N.N. Blokhin Russian Cancer Research CenterRussian Federation20251303202570197113Copyright © Валиев Т.Г., Ширин А.Д., Кохно А.В., Антипова А.С., Баранова О.Ю., Френкель М.А., Палладина А.Д., Сенченко М.А., 20252025Валиев Т.Г., Ширин А.Д., Кохно А.В., Антипова А.С., Баранова О.Ю., Френкель М.А., Палладина А.Д., Сенченко М.А.Valiev T.T., Shirin A.D., Kokhno A.V., Antipova A.S., Baranova O.Y., Frenkel M.A., Palladina A.D., Senchenko M.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.htjournal.ru/jour/article/view/611Введение

Введение. На протяжении последних десятилетий был разработан ряд классификаций и их обновлений для острых миелоидных лейкозов (ОМЛ) и миелодиспластических синдромов (МДС). Миелоидные новообразования (МН) после предшествующей терапии других заболеваний имели разные обозначения. В 5-й редакции классификации ВОЗ указанные новообразования определены как МН после цитотоксической терапии (пЦ-МН). Проблема выбора терапии пЦ-МН во многом связана с ранее проведенным лечением первого онкологического заболевания.

Цель

Цель: представить трудности классификации МН, индуцированных предшествующей цитотоксической химиотерапией онкогематологического заболевания и солидной опухоли, а также сложности определения прогноза и выбора метода лечения.

Основные сведения

Основные сведения. Описаны наблюдения МДС после химиотерапии ОМЛ и ОМЛ после противоопухолевой терапии остеосаркомы. Подробно изложены анамнез, диагностические процедуры, обоснован выбор лечения. Обсуждается стратификация риска больных МН, ассоциированными с предшествующей цитотоксической терапией.

Introduction

Introduction. Over the past decades, a number of classifications and their updates have been developed for acute myeloid leukemia (AML) and myelodysplastic syndromes (MDS). Myeloid neoplasms (MN) after previous therapy for other diseases had different designations. The fifth edition of the WHO classification provides the most accurate definition of these neoplasmes — MN post cytotoxic therapy (MN-pCT). The problem of choosing therapy for these MN is largely related to previous treatment of the first oncological disease.

Aim

Aim: to present the difficulties of classifying MN induced by previous cytotoxic chemotherapy of a hematologic malignancy and a solid tumor, as well as the difficulties of determining the prognosis and choosing a treatment method.

Main findings

Main findings. Clinical cases of MDS after chemotherapy of AML and AML after anticancer treatment of osteosarcoma are described. The anamnesis, diagnostics procedures are reported in detail, and the choice of therapy is justified. Risk stratification of patients with MN associated with previous cytotoxic therapy is discussed.

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The authors declare that there are no conflicts of interest present.