Division of Hematology and Medical Oncology, Mayo Clinic, USA.
Division of Biomedical Statistics and Informatics, Mayo Clinic, Jacksonville, FL, USA.
Br J Haematol. 2022 Feb;196(4):963-968. doi: 10.1111/bjh.17906. Epub 2021 Oct 25.
We report a comparative analysis of patients with therapy-related acute lymphoblastic leukaemia (tr-ALL) vs de novo ALL. We identified 331 patients with B-ALL; 69 (21%) were classified as tr-ALL. The most common prior malignancies were breast (23·2%) and plasma cell disorders (20·3%). Patients with tr-ALL were older (median 63·2 vs. 46·2 years, P < 0.001), more often female (66·7% vs. 43·5%, P < 0·001), and more likely to have hypodiploid cytogenetics (18·8% vs. 5·0%, P < 0·001). In multivariable analysis, patients with tr-ALL were less likely to achieve complete remission [odds ratio (OR) = 0·16, P < 0·001] and more likely to be minimal residual disease-positive (OR = 4·86, P = 0·01) but had similar OS after diagnosis and allo-haematopoietic cell transplantation.
我们报告了治疗相关急性淋巴细胞白血病（t r - ALL）与初发急性淋巴细胞白血病（de novo ALL）患者的对比分析。我们确定了 331 例 B-ALL 患者；69 例（21%）被归类为 t r - ALL。最常见的既往恶性肿瘤为乳腺癌（23.2%）和浆细胞疾病（20.3%）。t r - ALL 患者年龄更大（中位数 63.2 岁 vs. 46.2 岁，P<0.001），女性比例更高（66.7% vs. 43.5%，P<0.001），且更可能存在亚二倍体细胞遗传学异常（18.8% vs. 5.0%，P<0.001）。多变量分析显示，t r - ALL 患者完全缓解的可能性较低（比值比[OR] = 0.16，P<0.001），微小残留病阳性的可能性较高（OR = 4.86，P=0.01），但在诊断和异体造血细胞移植后，其总生存情况无显著差异。
