Острые миелоидные лейкозы и миелодиспластические синдромы, ассоциированные с предшествующей цитотоксической терапией. Характерные черты, прогноз и подходы к лечению

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

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.

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