Therapy-related acute lymphoblastic leukemia has distinct clinical and cytogenetic features compared to de novo acute lymphoblastic leukemia, but outcomes are comparable in transplanted patients.
Therapy-related acute lymphoblastic leukemia has distinct clinical and cytogenetic features compared to de novo acute lymphoblastic leukemia, but outcomes are comparable in transplanted patients.
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治疗相关急性淋巴细胞白血病与原发急性淋巴细胞白血病相比具有不同的临床和细胞遗传学特征，但移植患者的结局相似。
DOI：
10.3324/haematol.2018.193599
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发表时间：
2018-10
期刊：
影响因子：
10.1
通讯作者：
Pullarkat V
中科院分区：
文献类型：
--
作者：
Aldoss I;Stiller T;Tsai NC;Song JY;Cao T;Bandara NA;Salhotra A;Khaled S;Aribi A;Al Malki MM;Mei M;Ali H;Spielberger R;O'Donnell M;Snyder D;Slavin T;Nakamura R;Stein AS;Forman SJ;Marcucci G;Pullarkat V
与治疗相关的急性淋巴细胞性白血病的定义仍然不明确，因为缺乏认识到这一实体的定义特征的大型数据集。我们回顾了2000至2017年间在我们机构治疗的所有连续的成人急性淋巴细胞白血病病例，并确定了与治疗相关的病例--定义为急性淋巴细胞白血病，在此之前曾暴露于细胞毒性化疗和/或放射。在1022例急性淋巴细胞白血病患者中，93例(9.1%)与治疗有关。与治疗相关的急性淋巴细胞白血病的发病潜伏期从最初诊断开始的中位数为6.8年，携带MLL基因重排的患者比其他细胞遗传学患者的潜伏期更短。与初治的急性淋巴细胞白血病相比，与治疗相关的患者年龄更大(P<；0.01)，女性更多(P<；0.01)，MLL基因重排(P<；0.0001)和5/7染色体异常(P=0.02)也更多。尽管与治疗相关的急性淋巴细胞白血病患者的2年总生存率低于初治患者(46.0%vs.68.1%，P=0.001)，但多因素分析显示，既往接受细胞毒治疗(与治疗相关)并不独立影响患者的生存率(HR=1.32；95%CI：0.971.80，P=0.08)。接受异基因造血细胞移植的患者2年存活率分别为53.4%和58.9%，两组间差异无统计学意义(P=0.68)。总之，与治疗相关的急性淋巴细胞白血病在成人急性淋巴细胞白血病诊断中占很大比例，部分病例具有与治疗相关的髓系肿瘤类似的临床和细胞遗传学异常。尽管与治疗相关的急性淋巴细胞性白血病的存活率低于初发病例，但两个实体的异基因造血细胞移植结果是相似的。
Therapy-related acute lymphoblastic leukemia remains poorly defined due to a lack of large data sets recognizing the defining characteristics of this entity. We reviewed all consecutive cases of adult acute lymphoblastic leukemia treated at our institution between 2000 and 2017 and identified therapy-related cases - defined as acute lymphoblastic leukemia preceded by prior exposure to cytotoxic chemotherapy and/or radiation. Of 1022 patients with acute lymphoblastic leukemia, 93 (9.1%) were classified as therapy-related. The median latency for therapy-related acute lymphoblastic leukemia onset was 6.8 years from original diagnosis, and this was shorter for patients carrying the MLL gene rearrangement compared to those with other cytogenetics. When compared to de novo acute lymphoblastic leukemia, therapy-related patients were older (P<0.01), more often female (P<0.01), and had more MLL gene rearrangement (P<0.0001) and chromosomes 5/7 aberrations (P=0.02). Although therapy-related acute lymphoblastic leukemia was associated with inferior 2-year overall survival compared to de novo cases (46.0% vs. 68.1%, P=0.001), prior exposure to cytotoxic therapy (therapy-related) did not independently impact survival in multivariate analysis (HR=1.32; 95% CI: 0.97–1.80, P=0.08). There was no survival difference (2-year = 53.4% vs. 58.9%, P=0.68) between the two groups in patients who received allogenic hematopoietic cell transplantation. In conclusion, therapy-related acute lymphoblastic leukemia represents a significant proportion of adult acute lymphoblastic leukemia diagnoses, and a subset of cases carry clinical and cytogenetic abnormalities similar to therapy-related myeloid neoplasms. Although survival of therapy-related acute lymphoblastic leukemia was inferior to de novo cases, allogeneic hematopoietic cell transplantation outcomes were comparable for the two entities.
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影响因子：
4.8
作者：
Auer, RL;Oates, J;Milligan, DW
通讯作者：
Milligan, DW
影响因子：
6.2
作者：
Abdulwahab, Amal;Sykes, Jenna;Brandwein, Joseph M.
通讯作者：
Brandwein, Joseph M.
影响因子：
45.3
作者：
Ostgard, Lene Sofie Granfeldt;Medeiros, Bruno C.;Norgaard, Jan Maxwell
通讯作者：
Norgaard, Jan Maxwell
加利福尼亚州西班牙裔在成年急性淋巴细胞白血病的终生发病率很高。
DOI：
10.1158/1055-9965.epi-07-2949
发表时间：
2009-02
期刊：
Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology
影响因子：
--
作者：
Pullarkat ST;Danley K;Bernstein L;Brynes RK;Cozen W
通讯作者：
Cozen W
影响因子：
6.5
作者：
Ganzel, Chezi;Devlin, Sean;Tallman, Martin S.
通讯作者：
Tallman, Martin S.