Department of Haematology and Oncology, Internal Medicine III, Clemenshospital Muenster, Muenster, Germany.
Br J Haematol. 2014 Apr;165(1):17-38. doi: 10.1111/bjh.12750. Epub 2014 Feb 1.
Acute myeloid leukaemia (AML) is a heterogeneous disease. Prognosis of AML is influenced both by patient-specific as well as disease-specific factors. Age is the most prominent patient-specific risk factor, while chromosomal aberrations are the strongest disease-specific risk factors. For patients with cytogenetically normal AML, prognosis can be specified by mutational status of the genes NPM1, FLT3 and CEBPA. A growing number of recurrent mutations in additional genes have recently been identified, for which the prognostic effect yet has to be determined. Performance status, geriatric assessment, secondary leukaemia following myelodysplastic syndrome or cytotoxic treatment, common laboratory parameters, leukaemic stem cell frequency, bone marrow microenvironment, gene expression levels, epigenetic changes, micro-RNA's as well as kinetics and depth of response to treatment influence prognosis of AML patients. Despite the high number of established risk factors, only few predictive markers exist which can truly aid therapy decisions in patients with AML.
急性髓系白血病（AML）是一种异质性疾病。AML 的预后受到患者自身和疾病特异性因素的影响。年龄是最重要的患者特异性危险因素，而染色体异常是最强的疾病特异性危险因素。对于细胞遗传学正常的 AML 患者，基因突变状态可通过 NPM1、FLT3 和 CEBPA 基因来预测。最近已经发现了越来越多的其他基因的复发性突变，但其预后影响尚待确定。一般来说，体能状态、老年评估、骨髓增生异常综合征或细胞毒性治疗后的继发性白血病、常见的实验室参数、白血病干细胞频率、骨髓微环境、基因表达水平、表观遗传变化、微小 RNA 以及对治疗的反应速度和深度都会影响 AML 患者的预后。尽管已经确定了大量的危险因素，但真正能够帮助 AML 患者做出治疗决策的预测标志物却很少。
