Department of Hematology, Hôpital Edouard Herriot, Lyon, France.
Leuk Res. 2012 Sep;36(9):1112-8. doi: 10.1016/j.leukres.2012.04.020. Epub 2012 May 28.
Forty-seven percent of adults with acute myeloid leukemia (AML) who entered the ALFA-9802 trial and achieved a first complete remission (CR) experienced a first relapse. We examined the outcome of these 190 adult patients. Eighty-four patients (44%) achieved a second CR. The median overall survival (OS) after relapse was 8.9 months with a 2-year OS at 25%. Factors predicting a better outcome after relapse were stem cell transplant (SCT) performed in second CR and a first CR duration >1 year. Risk groups defined at the time of diagnosis and treatment received in first CR also influenced the outcome after relapse. The best results were obtained in patients with core binding factor (CBF)-AML, while patients initially defined as favorable intermediate risk showed a similar outcome after relapse than those initially entering the poor risk group. We conclude that most adult patients with recurring AML could not be rescued using current available therapies, although allogeneic SCT remains the best therapeutic option at this stage of the disease.
47% 进入 ALFA-9802 试验并达到首次完全缓解 (CR) 的急性髓系白血病 (AML) 成人患者首次复发。我们检查了这 190 名成年患者的结果。84 名患者 (44%) 达到了第二次 CR。复发后的中位总生存期 (OS) 为 8.9 个月，2 年 OS 为 25%。复发后预后较好的预测因素包括第二次 CR 中进行的干细胞移植 (SCT) 和首次 CR 持续时间 >1 年。在首次 CR 中接受治疗时定义的风险组也影响复发后的结果。在核心结合因子 (CBF)-AML 患者中获得了最佳结果，而最初被定义为有利的中危患者在复发后与最初进入低危组的患者具有相似的结果。我们得出的结论是，尽管同种异体 SCT 仍然是疾病现阶段的最佳治疗选择，但目前可用的疗法无法挽救大多数复发的 AML 成年患者。
