急性髓系白血病

Acute myeloid leukaemia (AML) is a life-threatening haematological malignancy that predominantly occurs in older adults.

存在许多亚型，其中的急性早幼粒细胞白血病应受到特异性治疗。

Characteristically, abnormal blasts are present in the peripheral blood and normal haematopoiesis is reduced. Definitive diagnosis requires bone marrow biopsy. Presence of ≥20% blast cells in the peripheral blood and/or bone marrow confirms the diagnosis.

Cytogenetic, genetic, and epigenetic abnormalities are prognostically important and affect patient management.

大多数患者接受了诱导化疗、巩固和维持方案的治疗。 造血干细胞移植也可用于挑选过的患者。

快速鉴别急性早幼粒细胞白血病至关重要，因为该病相关的凝血障碍可能会危及生命。

虽然大多数患者可达到完全缓解，但高复发率仍可导致较差的总生存率。

Acute myeloid leukaemia (AML) is a life-threatening haematological malignancy caused by clonal expansion of myeloid blasts in the bone marrow, peripheral blood, or extramedullary tissues. The presence of ≥20% blast cells in the bone marrow or peripheral blood confirms the diagnosis.[1]Arber DA, Orazi A, Hasserjian R, et al. The 2016 revision to the World Health Organization classification of myeloid neoplasms and acute leukemia. Blood. 2016 May 19;127(20):2391-405. http://www.bloodjournal.org/content/127/20/2391.long?sso-checked=true http://www.ncbi.nlm.nih.gov/pubmed/27069254?tool=bestpractice.com Specific clonal cytogenetic abnormalities, such as t(8;21)(q22;q22), inv(16)(p13;q22), t(16;16)(p13;q22), and t(15;17)(q22;q12), also define AML irrespective of the blast count.[1]Arber DA, Orazi A, Hasserjian R, et al. The 2016 revision to the World Health Organization classification of myeloid neoplasms and acute leukemia. Blood. 2016 May 19;127(20):2391-405. http://www.bloodjournal.org/content/127/20/2391.long?sso-checked=true http://www.ncbi.nlm.nih.gov/pubmed/27069254?tool=bestpractice.com [2]Döhner H, Estey E, Grimwade D, et al. Diagnosis and management of AML in adults: 2017 ELN recommendations from an international expert panel. Blood. 2017 Jan 26;129(4):424-47. https://ashpublications.org/blood/article/129/4/424/36196/Diagnosis-and-management-of-AML-in-adults-2017-ELN http://www.ncbi.nlm.nih.gov/pubmed/27895058?tool=bestpractice.com AML may arise de novo or secondary to a pre-existing haematological disorder, such as myelodysplastic syndrome.[1]Arber DA, Orazi A, Hasserjian R, et al. The 2016 revision to the World Health Organization classification of myeloid neoplasms and acute leukemia. Blood. 2016 May 19;127(20):2391-405. http://www.bloodjournal.org/content/127/20/2391.long?sso-checked=true http://www.ncbi.nlm.nih.gov/pubmed/27069254?tool=bestpractice.com

The acute promyelocytic leukaemia (APML) subtype of AML is characterised by a distinctive cytomorphology (hypergranular promyelocytes with bilobed nuclei and bundles of Auer rods), a tendency for coagulopathy (due to thrombocytopenia and fibrinolysis), and a specific t(15;17) translocation resulting in a novel PML/RAR-alpha fusion gene.[Figure caption and citation for the preceding image starts]: 急性早幼粒细胞白血病患者的外周血片表现出早幼粒细胞增加，一些有束状奥氏小体由 Drs K. Raj 和 P. Mehta 提供；经患者同意后使用 [Citation ends].[Figure caption and citation for the preceding image starts]: 急性早幼粒细胞白血病患者的外周血片表现出早幼粒细胞增加及双叶核与奥氏小体束由 Drs K. Raj 和 P. Mehta 提供；经患者同意后使用 [Citation ends].