内科精品教学（重庆医科大学）13Leukemia.pptVIP

Stratification based on cytogenetic and molecular entities Impact of karyotype on outcome in younger adults with AML. Overall survival is shown for adults with AML (median age 43 years, range 16–59) treated in successive Medical Research Council/National Cancer Research Institute trials (MRC AML10, AML12, AML15). A) Outcome of cytogenetic entities specified in the 2008 WHO classification3 B) Outcome of de novo, therapy-related and other secondary AML according to cytogenetic risk group (using revised MRC classification provided in Table 1) All patients with t(15;17) received an extended course of ATRA in addition to anthracycline-based chemotherapy. Acute Leukemia Bleeding platelet transfusion: no signs of bleeding but PLT10000/㎜3 signs of bleeding , PLT 50000/ ㎜3 Acute Leukemia Chemotherapy化学治疗： Chemotherapeutic Protocol in ALL化疗方案： (1).VP and VDP,VDLP (2)High dose Ara-C(HDAC) High dose methotrexate （HDMTX） Acute Leukemia Chemotherapeutic protocols in AML young adult APL non-APL ATRA+ anthracycline DA3+7 AS2O3 inv 16 or t(8;21) 中 差 SCT high-dose allo-SCT Acute Leukemia M3(APL) induction remission therapy (1)ALL-Trans- retinoic acid（ATRA）45mg/m2/day P.O till CR,or addition of Idarubicin .no Ara-c needed. (2)As2O3 20mg/day 30days Acute Leukemia induction of remission(non-APL) DA(3+7) daunorubicin and cytarabine D 45mg/m2 day 1,2,3 Ara-C 100mg/m2 day 1~7 CR Rate 60% AML with multilineage dysplasia FAT fludarabine and cytarabine and topotecan CR Rate 80% Acute Leukemia consolidation therapy (1)Patients with t(8:21), or inv(16)etc. high-dose cytarabine ，at least three cycles ，cure rate of 60%–70% (2)M3(APL) ATRA+D or ID As2O3 (3) chemotherap