Balanced chromosome abnormalities inv(16) and t(15;17) in therapy-related myelodysplastic syndromes and acute leukemia: Report from an international workshop
Balanced chromosome abnormalities inv(16) and t(15;17) in therapy-related myelodysplastic syndromes and acute leukemia: Report from an international workshop
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DOI：
10.1002/gcc.10043
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发表时间：
2002-04-01
影响因子：
3.7
通讯作者：
Pedersen-Bjergaard, J
中科院分区：
文献类型：
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作者：
Andersen, MK;Larson, RA;Pedersen-Bjergaard, J
研讨会确定了48名未入选的与治疗相关的骨髓增生异常综合征或急性髓系白血病(t-mids/t-AML)和INV(16)患者，以及41名因恶性或非恶性疾病接受化疗(CT)和/或放疗(RT)后t(15；17)的患者。原发疾病：乳腺癌33例，淋巴瘤24例，其他各种实体瘤30例，非恶性疾病2例。以往的一般治疗类型为仅有10例inv(16)患者和12例t(15；17)患者的RT，24例inv(16)患者和18例t(15；17)患者的烷化剂加拓扑异构酶11抑制剂，5例inv(16)患者和2例t(15；17)患者的拓扑异构酶11抑制剂，各亚组仅6例烷化药物，每个亚组3例其他类型的化疗。大多数接受CT治疗的患者(69%)也接受了RT。T-MDS/t-AML的潜伏期较短：inv(16)患者的中位数为22个月，t(15；17)患者的中位数为29个月。26例(54%)inv(16)患者和17例(41%)t(15；17)患者有额外的细胞遗传学异常，这与两个亚组的年龄和生存期无关。8、21和22号染色体三体和del(7q)是inv(16)亚组中最常见的附加异常，而t(15；17)亚组中最常见的是+8、-5和del(16q)。48例inv(16)患者中38例(79%)为临床t-AML，t(15；17)患者中38例(93%)为t-AML。在39例接受强化治疗的患者中，33例(85%)获得完全缓解，而在35例接受强化治疗的患者中，24例(69%)获得完全缓解。在两个细胞遗传学亚组中，强化治疗患者的中位总生存期为29个月。在INV(16)亚组中，年龄在55岁以下的患者与年龄较大的患者相比存活时间更长(P=0.006)。这项研究支持这样的观察，即有inv(16)和t(15；17)的t-MDS/t-AML通常与先前使用拓扑异构酶11抑制剂治疗有关；然而，值得注意的是，只进行放射治疗的频率很高，t(15；17)和inv(16)的治疗频率分别为29%和21%。在这项研究中，强化化疗的有效率与新发疾病的有效率相当。(C)2002年Wiley-Liss，Inc.
The Workshop identified 48 unselected patients with therapy-related myelodysplastic syndrome or acute myeloid leukemia (t-MIDS/t-AML) and inv(16), and 41 patients with t(15; 17) after chemotherapy (CT) and/or radiotherapy (RT) for a malignant or nonmalignant disease. The primary diseases were: breast cancer, 33 patients; lymphomas, 24 patients; various other solid tumors, 30 patients; and nonmalignant diseases, 2 patients. The general type of previous therapy was RT only in 10 patients with an inv(16) and in 12 patients with a t(15; 17), alkylating agents plus topoisomerase 11 inhibitors in 24 patients with an inv (16) and in 18 patients with a t(15; 17), topoisomerase 11 inhibitors only in 5 patients with an inv(16) and in 2 patients with a t(15; 17), alkylating agents only in 6 patients in each subgroup, and other types of chemotherapy in 3 patients in each subgroup. Most CT-treated patients (69%) also received RT. The latency period to development of t-MDS/t-AML was short: a median of 22 months in patients with inv(16) and 29 months in patients with t(15; 17). Twenty-six patients (54%) with an inv(16) and 17 patients (41%) with a t(15; 17) had additional cytogenetic abnormalities, which were unrelated to age and survival in both subgroups. Trisomy of chromosomes 8, 21, and 22 and del(7q) were the most frequent additional abnormalities in the inv(16) subgroup, whereas +8, -5, and del(16q) were most frequent in the t(15; 17) subgroup. The disease was overt t-AML in 38/48 patients (79%) with an inv(16) and in 38/41 patients (93%) with a t(15; 17). Thirty-three of 39 intensively treated patients (85%) with an inv(16) obtained a complete remission, whereas 24 of 35 intensively treated patients (69%) with a t(15; 17) obtained a complete remission. The median overall survival of intensively treated patients was 29 months in both cytogenetic subgroups. In the inv(16) subgroup, patients younger than 55 years of age had a longer survival when compared with older patients (P = 0.006). The study supports the observation that t-MDS/t-AML with inv(16) and t(15; 17) is often associated with prior therapy with topoisomerase 11 inhibitors; however, a notable finding was the high frequency of treatment with only radiotherapy, 29% of t(15; 17) and 21 % of inv(16). Response rates to intensive chemotherapy in this study were comparable to those of de novo disease. (C) 2002 Wiley-Liss, Inc.