改善了与儿科治疗相关的AML的治疗结果和治疗指南:AML-BFM研究小组建议
Stephanie Sendker1, Markus Schneider2, Evangelia Antoniou2
1University Childrens Hospital Essen, Essen, Germany.
Blood advances
|February 19, 2025
概括
在儿童中,与治疗相关的急性髓性白血病 (tAML) 显示出更好的生存率,但仍然比新的AML更糟. 在缓解期内血造干细胞移植是关键,辐射和不良遗传学是不良预后.
科学领域:
- 儿科瘤学 儿科瘤学
- 血液学 血液学 血液学
- 癌症遗传学 癌症遗传学
背景情况:
- 与治疗相关的急性髓性白血病 (tAML) 是癌症治疗后的一种严重并发症.
- 了解儿科tAML对于改善患者的治疗结果至关重要.
研究的目的:
- 确定儿科tAML的临床和病理意义.
- 确定治疗含义,并确定儿科tAML的不良预后因素.
主要方法:
- 对1993年至2019年期间被诊断患有tAML的119名儿科患者的分析.
- 将tAML的特征与新的AML进行比较.
- 预后因素和生存率的评估.
主要成果:
- 与 de novo AML 相比,tAML 与较低的白细胞计数和中枢神经系统参与有关.
- 患有tAML的患者通常具有不利的细胞遗传学,包括KMT2A重组和-7 / del7q).
- 随着时间的推移,生存率显著提高,近年来达到50%±10%,但仍然低于新的AML.
结论:
- 在两次诱导周期后没有白血病 (NEL) 证据的患者中,造血干细胞移植 (HSCT) 显著改善了生存率.
- 不良的细胞遗传学,先前的辐射暴露 (>35 Gy) 和短潜伏期 (≤1年) 是强烈的不良预后.
- 持续的研究和优化的治疗策略,包括HSCT,对于改善儿科tAML结果至关重要.
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