Therapy-related myeloid leukemia.
Therapy-related myeloid leukemia.
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DOI：
10.1053/j.seminoncol.2008.04.012
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发表时间：
2008-08
影响因子：
4
通讯作者：
Larson RA
中科院分区：
文献类型：
--
作者：
Godley LA;Larson RA
治疗相关的骨髓增生异常综合征和急性髓系白血病(t-MDS/t-AML)被认为是化疗、放射治疗、免疫抑制治疗或这些方式的组合引起的突变事件的直接后果，用于治疗先前存在的疾病。与初发AML患者相比，这些患者的历史结果一直很差。T-AML的细胞遗传学异常与初发AML相似，但t-AML中不利的细胞遗传学异常，如复杂的核型或5号和/或7号染色体的缺失或丢失的频率要高得多。T-AML患者的存活率因细胞遗传学风险组而异，具有有利风险核型的患者预后较好。治疗建议应基于表现状态和核型。更深入地了解导致患者易患与治疗相关的髓系白血病的因素将有助于临床医生在治疗原发疾病后更仔细地监测患者。最终，这一知识可能会影响最初的治疗策略，目标是减少这种严重并发症的发生率。
Therapy-related myelodysplastic syndrome and acute myeloid leukemia (t-MDS/t-AML) are thought to be the direct consequence of mutational events induced by chemotherapy, radiation therapy, immunosuppressive therapy, or a combination of these modalities, given for a pre-existing condition. The outcomes for these patients have been poor historically compared to people who develop de novo AML. The spectrum of cytogenetic abnormalities in t-AML is similar to de novo AML, but the frequency of unfavorable cytogenetics, such as a complex karyotype or deletion or loss of chromosomes 5 and/or 7, is considerably higher in t-AML. Survival varies according to cytogenetic risk group in t-AML patients, with better outcomes being observed in those with favorable-risk karyotypes. Treatment recommendations should be based on performance status and karyotype. A deeper understanding of the factors that predispose patients to the development of therapy-related myeloid leukemia would help clinicians monitor patients more carefully after treatment for a primary condition. Ultimately, this knowledge could influence initial treatment strategies with the goal of decreasing the incidence of this serious complication.