急性髓系白血病的晚期复发：特征与预后分析。
Late relapses in acute myeloid leukemia: analysis of characteristics and outcome.
机构信息
Department of Leukemia, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 428, Houston, TX 77030, USA.
出版信息
Leuk Lymphoma. 2010 May;51(5):778-82. doi: 10.3109/10428191003661852.
Relapse after 5 years of complete remission (CR) is uncommon in acute myeloid leukemia (AML). Among 2347 patients seen between 1980 and 2008, 1366 achieved CR; 942 relapsed. Eleven (1.16% of all relapses) relapsed after a CR of >5 years. The median age was 66 years (range, 37-79). Initial therapy was cytarabine plus anthracycline in six, amsacrine-based in three, and other in two. The median CR1 duration was 81 months (range, 60-137). At relapse, the karyotype was different from the initial finding in five of eight (63%) patients with available data. Treatment for relapse included cytarabine with anthracycline in eight, and other in three patients, with a second CR (CR2) achieved in four (36%). The median CR2 duration was 1 month (range, 0-37), and median survival after relapse was 6.4 months (range, 1-39). Late relapses in AML are infrequent, with poor response to therapy. Karyotype at relapse is frequently different, raising the question of second AML versus relapse with the original clone.
在急性髓细胞白血病（AML）中，完全缓解（CR）后 5 年复发并不常见。在 1980 年至 2008 年间观察到的 2347 例患者中，有 1366 例达到 CR；942 例复发。11 例（所有复发的 1.16%）在 CR 超过 5 年后复发。中位年龄为 66 岁（范围，37-79）。初始治疗方案为阿糖胞苷加蒽环类药物 6 例，安吖啶为基础 3 例，其他方案 2 例。CR1 中位持续时间为 81 个月（范围，60-137）。在复发时，8 例中有 5 例（63%）患者可获得数据，其核型与初始发现不同。复发的治疗方案包括阿糖胞苷加蒽环类药物 8 例，其他方案 3 例，4 例（36%）患者获得第二次完全缓解（CR2）。CR2 的中位持续时间为 1 个月（范围，0-37），复发后中位生存时间为 6.4 个月（范围，1-39）。AML 的迟发性复发罕见，对治疗反应不佳。复发时的核型通常不同，这引发了第二个 AML 还是原始克隆复发的问题。
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