Department of Leukemia, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 428, Houston, TX 77030, USA.
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。
