Department of Hematology and Oncology, Medical University of South Carolina, Charleston, SC.
Clin Lymphoma Myeloma Leuk. 2023 Aug;23(8):583-588. doi: 10.1016/j.clml.2023.04.011. Epub 2023 Apr 28.
Acute erythroid leukemia (AEL) is a highly aggressive subtype of acute myeloid leukemia. Since the first recognition of an erythroid-predominant hematologic malignancy in the early 20th century, AEL has gone through a turnstile of changing definitions and nomenclature, including eritoleucemia, erythremic myelosis, AML-M6 and pure erythroid leukemia. Ever-changing diagnostic criteria and under recognition have stifled our understanding of, and therapeutic options for, this rare erythroid-predominant myeloid neoplasm. It is now well-documented that true AEL, which is characterized primarily by immature erythroid proliferation, often harbors highly complex cytogenetic changes and multiple, deleterious TP53 mutations. These cytogenetic and molecular characteristics render current treatment approaches largely ineffective, and signal an urgent need for novel therapeutic modalities. Due to its rarity and aggressive nature, concerted collaborative efforts must be undertaken in order to improve the outcomes and treatment options for patients with AEL.
急性红细胞白血病(AEL)是一种高度侵袭性的急性髓系白血病亚型。自 20 世纪初首次发现以红细胞为主的血液恶性肿瘤以来,AEL 经历了定义和命名的不断变化,包括红白血病、红细胞增多性骨髓纤维化、AML-M6 和纯红细胞白血病。不断变化的诊断标准和认识不足阻碍了我们对这种罕见的以红细胞为主的髓系肿瘤的理解和治疗选择。现在已有充分的证据表明,以不成熟红细胞增生为主要特征的真正的 AEL 常伴有高度复杂的细胞遗传学改变和多个有害的 TP53 突变。这些细胞遗传学和分子特征使得当前的治疗方法基本无效,并表明迫切需要新的治疗方式。由于其罕见性和侵袭性,必须进行协同合作的努力,以改善 AEL 患者的预后和治疗选择。