Deming Department of Internal Medicine, Tulane University School of Medicine, New Orleans, LA, USA.
LSU School of Medicine, New Orleans, LA, USA.
Leuk Lymphoma. 2021 Jan;62(1):203-210. doi: 10.1080/10428194.2020.1817435. Epub 2020 Sep 29.
The prognostic significance and optimal management of tetraploidy/near-tetraploidy acute myeloid leukemia (T/NT AML) remains unclear given its limited data. This is especially true after factoring in additional chromosomal alterations, which carry their own prognostic weight. Here, we analyze 128 cases of T/NT in AML from the literature along with two additional cases, which is the largest review of this subject to date. Based on our retrospective analysis, we found that regardless of the risk status attributed to cytogenetics, the prognosis of tetraploid or near-tetraploid AML is dismal and should be incorporated within the unfavorable risk group. Complete remission is paramount to survival in this population. Specific induction protocols for high-risk AML appear to have higher rates of complete remission in the T/NT AML population. Moreover, longer overall survival can be achieved with chemotherapy followed by allogeneic stem cell transplantation at first complete remission.
鉴于其数据有限，四倍体/近四倍体急性髓系白血病（T/NT AML）的预后意义和最佳治疗方法仍不清楚。在考虑到额外的染色体改变后，情况更是如此，因为这些改变具有自己的预后权重。在这里，我们分析了文献中 128 例 AML 中的 T/NT 病例，以及另外两例病例，这是迄今为止对此主题的最大回顾。根据我们的回顾性分析，我们发现，无论归因于细胞遗传学的风险状况如何，四倍体或近四倍体 AML 的预后都很糟糕，应归入不良风险组。完全缓解是该人群生存的关键。高危 AML 的特定诱导方案似乎在 T/NT AML 人群中具有更高的完全缓解率。此外，在首次完全缓解时，采用化疗后进行异基因干细胞移植可以实现更长的总生存期。
