文章：

治疗相关正常核型急性髓系白血病患者的特征及结局

Characteristics and outcomes of patients with therapy-related acute myeloid leukemia with normal karyotype

原文发布日期：2020-05-04

DOI: 10.1038/s41408-020-0316-3

类型: Article

开放获取: 是

英文摘要：

Normal karyotype in therapy-related acute myeloid leukemia (t-AML) is rare and the relative contribution of prior exposure to chemotherapy or radiotherapy to outcomes in these patients remains uncertain. We performed a retrospective study of 742 patients with newly diagnosed AML and normal karyotype (t-AML, n = 61, and non-t-AML, n = 681). Patients with t-AML were older but had a similar mutational profile compared to those with non-t-AML. Overall survival (OS) and relapse-free survival (RFS) were significantly worse for patients with t-AML (P < 0.01 and P = 0.02, respectively). Patients with t-AML had a higher cumulative incidence of death in remission (51% versus 16%, P < 0.01), but not higher cumulative incidence of relapse (42% versus 56%, respectively, P = 0.21). Both intensive induction and allogeneic hematopoietic stem cell transplantation in first remission were associated with improved OS and RFS in non-t-AML but not in t-AML. Overall, although disease biology appears similar between t-AML and non-t-AML with normal karyotype as indicated by similar risks of relapse, death in remission is the main driver of inferior outcome in t-AML. Careful therapeutic decisions are required to mitigate potential treatment-related toxicity in this rare subgroup of patients with t-AML and normal karyotype.
 

摘要翻译： 

正常核型的治疗相关急性髓系白血病（t-AML）较为罕见，且既往化疗或放疗暴露对这些患者预后的相对贡献仍不确定。我们对742名新诊断的急性髓系白血病和正常核型患者（t-AML，n=61；非t-AML，n=681）进行了回顾性研究。t-AML患者年龄较大，但突变谱与非t-AML患者相似。t-AML患者的总生存期（OS）和无复发生存期（RFS）显著更差（分别为P<0.01和P=0.02）。t-AML患者的缓解期死亡累积发生率较高（51%对16%，P<0.01），但复发累积发生率不高（分别为42%对56%，P=0.21）。强化诱导和首次缓解期进行异基因造血干细胞移植在非t-AML中与OS和RFS改善相关，但在t-AML中无此关联。总体而言，尽管t-AML和非t-AML在疾病生物学上似乎相似，表现为复发风险相似，但缓解期死亡是t-AML预后较差的主要驱动因素。对于这一罕见的正常核型t-AML患者亚组，需要谨慎的治疗决策以减轻潜在的治疗相关毒性。

原文链接：

Characteristics and outcomes of patients with therapy-related acute myeloid leukemia with normal karyotype