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首页> 外文期刊>The Internet Journal of Academic Physician Assistants >The Adult Leukemias - Part 1: Acute Myeloid Leukemia
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The Adult Leukemias - Part 1: Acute Myeloid Leukemia

机译：成人白血病-第1部分：急性髓性白血病

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Acute Myeloid or Myelogenous Leukemia (AML) is a rare malignancy characterized by bone marrow infiltration of abnormal hematopoietic precursors and resulting disruption of normal production of red blood cells, white blood cells, or platelets. The FAB (French-American-British) classification subdivides AML into separate groups depending on abnormal cell morphology. Secondary AML may occur after treatment with alkylating agents and usually has a poorer prognosis than de novo leukemia. Overall prognosis remains guarded, with cure rates ranging from 0-60% depending on patient characteristics, leukemia cell type, and cytogenetic abnormalities. AML is sometimes discovered on a routine blood test in an asymptomatic individual; more often patients have constitutional complaints arising from anemia, leukocytosis or neutropenia, or thrombocytopenia. Blasts may be present in the peripheral blood, and are >30% in the bone marrow. In AML, >3% of these blasts are myeloperoxidase positive on staining. The presence of chromosomal translocations such as t(15;17) and t(8;21) is a good prognostic indicator; having normal chromosomes is intermediate in prognosis, and any chromosomal deletion or addition (-5, -7, trisomy 8) is a poor prognostic indicator. Treatment is tailored to the specific abnormality and FAB subtype, with particular subtypes having more favorable outcomes. Subcategorizing leukemias into different groups based on morphology, cytogenetics, and predicted outcome may lead to more specific and effective chemotherapeutic regimens and hopefully more cures in AML patients. INTRODUCTION to AML Acute myeloid leukemia (AML) is a rare malignancy that is characterized by infiltration of bone marrow by abnormal hematopoietic progenitors that disrupts normal production of erythroid, myeloid, and/or megakaryocytic cell lines. It can be subdivided by the FAB (French-American-British) system into specific types depending on which cell lines are involved. AML subtypes (M0- M7) are determined by cell morphology with particular subtypes such as M3 (acute promyelocytic leukemia or APL) having a more favorable outcome. By classifying AML in this manner, developed treatments can more specifically eradicate the particular defective cell clone and hopefully provide a better outcome after therapy. More relevant than subtype, however, is the leukemia cell karyotype (cytogenetics). See table1.
机译：急性髓样或骨髓性白血病（AML）是一种罕见的恶性肿瘤，其特征是异常造血前体的骨髓浸润并导致红细胞，白细胞或血小板正常产生的破坏。 FAB（法语-美国-英国）分类根据异常细胞形态将AML分为不同的组。继发性AML可能在用烷基化剂治疗后发生，通常比从头白血病的预后更差。总体预后仍然保持谨慎，治愈率的范围为0-60％，具体取决于患者特征，白血病细胞类型和细胞遗传学异常。有时会在无症状的人的常规血液检查中发现AML。更常见的是，患者因贫血，白细胞增多或中性粒细胞减少或血小板减少引起体质不适。爆炸可能存在于外周血中，并且在骨髓中> 30％。在AML中，> 3％的胚细胞在染色时是髓过氧化物酶阳性的。 t（15; 17）和t（8; 21）等染色体易位的存在是良好的预后指标。具有正常染色体的染色体在预后中处于中间状态，任何染色体的缺失或增加（-5，-7，三体性8）都不是预后良好的指标。根据特定的异常和FAB亚型量身定制治疗方案，特定亚型的预后更佳。根据形态学，细胞遗传学和预测的结果将白血病分为不同的类别，这可能会导致更特异和有效的化疗方案，并有望为AML患者提供更多的治疗方法。 AML简介急性髓细胞性白血病（AML）是一种罕见的恶性肿瘤，其特征是异常造血祖细胞浸润骨髓，破坏了类红血球，髓样和/或巨核细胞系的正常生产。根据涉及的细胞系，FAB（法国-美国-英国）系统可以将其细分为特定类型。 AML亚型（M0至M7）通过细胞形态来确定，其中特定亚型（例如M3（急性早幼粒细胞白血病或APL））的结局更佳。通过以这种方式对AML进行分类，发达的治疗方法可以更特异性地根除特定的缺陷细胞克隆，并有望在治疗后提供更好的治疗效果。然而，比亚型更重要的是白血病细胞核型（细胞遗传学）。参见表1。

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