Fred Hutchinson Cancer Research Center, Seattle, Washington 98109-1024, USA.
Oncology (Williston Park). 2012 Aug;26(8):706-12.
In acute myeloid leukemia, the karyotype of the leukemic cell is the most powerful predictor of treatment outcome. Approximately 30% of cases of AML have an unfavorable karyotype, and if treated with conventional chemotherapy, a complete response rate of about 50% and a 5-year overall survival of 10% to 20% are expected. Of those in the unfavorable group, almost half will have a complex karyotype, which is associated with a poorer outcome, and 40% of those will have a monosomal karyotype, which carries an even worse prognosis. The best chance for cure for patients with an unfavorable karyotype is seen in those who achieve a complete response and proceed to allogeneic transplant. For patients who are not candidates for aggressive therapy, preliminary data suggest that outcomes at least equivalent to those seen with standard chemotherapy can be obtained using azacitidine or decitabine.
在急性髓细胞白血病中，白血病细胞的核型是治疗结果的最有力预测指标。大约 30%的 AML 病例具有不良核型，如果采用常规化疗，预计完全缓解率约为 50%，5 年总生存率为 10%至 20%。在不良核型组中，几乎一半的患者会出现复杂核型，这与较差的预后相关，而 40%的患者会出现单体核型，这预示着更差的预后。对于具有不良核型的患者，实现完全缓解并进行异基因移植是治愈的最佳机会。对于不适合积极治疗的患者，初步数据表明，使用阿扎胞苷或地西他滨至少可以获得与标准化疗相当的结果。
