Pemmaraju Naveen, Kantarjian Hagop, Garcia-Manero Guillermo, Pierce Sherry, Cardenas-Turanzas Marylou, Cortes Jorge, Ravandi Farhad
Department of Leukemia, The University of Texas M.D. Anderson Cancer Center, Houston, Texas.
Am J Hematol. 2015 Jan;90(1):27-30. doi: 10.1002/ajh.23858. Epub 2014 Oct 18.
The outcome of patients with relapsed acute myeloid leukemia (AML) remains unsatisfactory, with few available effective therapies. Increased understanding of the biology of the disease has led to the identification of novel therapeutic agents, several of which have been evaluated in recently conducted clinical trials. We sought to determine whether the introduction of these agents as well as modern supportive care measures has already translated to better outcomes. We examined the outcomes of 1,056 patients with AML in first relapse treated between January 1993 and December 2013 at our institution. As previously reported, the independent prognostic factors for survival after first relapse included age at relapse, cytogenetics, and duration of first complete remission. Upon multivariable analysis, treatment era was an independent predictor of survival, with significant improvement in overall survival between 2008 and 2013 as compared to prior time periods. Modern supportive care measures as well as participation in clinical trials of novel agents are already improving the outcomes in first relapse.
复发急性髓系白血病（AML）患者的治疗结果仍不尽人意，有效的治疗方法寥寥无几。对该疾病生物学特性的深入了解促使人们发现了新型治疗药物，其中几种已在近期开展的临床试验中进行了评估。我们试图确定这些药物的引入以及现代支持性护理措施是否已经带来了更好的治疗效果。我们研究了1993年1月至2013年12月期间在我们机构接受首次复发治疗的1056例AML患者的治疗结果。如先前报道，首次复发后生存的独立预后因素包括复发时的年龄、细胞遗传学以及首次完全缓解的持续时间。多变量分析显示，治疗时代是生存的独立预测因素，与之前的时间段相比，2008年至2013年期间总生存率有显著提高。现代支持性护理措施以及参与新型药物的临床试验已经改善了首次复发患者的治疗结果。
