Unfavorable, complex, and monosomal karyotypes: the most challenging forms of acute myeloid leukemia.
Unfavorable, complex, and monosomal karyotypes: the most challenging forms of acute myeloid leukemia.
复制标题
作者：
J. Orozco;F. Appelbaum
在急性髓系白血病中，白血病细胞的核型是治疗结果最有力的预测因子。大约30%的AML病例具有不利的核型，如果采用常规化疗治疗，预计完全缓解率约为50%，5年总生存率为10%至20%。在不利组中，近一半的人具有复杂的核型，这与较差的预后相关，其中40%的人具有单体核型，这导致更差的预后。对于具有不利核型的患者来说，治愈的最佳机会是那些获得完全缓解并进行同种异体移植的患者。对于不适合积极治疗的患者，初步数据表明，使用阿扎胞苷或地西他滨可以获得至少与标准化疗相同的结果。
In acute myeloid leukemia, the karyotype of the leukemic cell is the most powerful predictor of treatment outcome. Approximately 30% of cases of AML have an unfavorable karyotype, and if treated with conventional chemotherapy, a complete response rate of about 50% and a 5-year overall survival of 10% to 20% are expected. Of those in the unfavorable group, almost half will have a complex karyotype, which is associated with a poorer outcome, and 40% of those will have a monosomal karyotype, which carries an even worse prognosis. The best chance for cure for patients with an unfavorable karyotype is seen in those who achieve a complete response and proceed to allogeneic transplant. For patients who are not candidates for aggressive therapy, preliminary data suggest that outcomes at least equivalent to those seen with standard chemotherapy can be obtained using azacitidine or decitabine.