Therapy-related myeloid neoplasms are neoplastic processes arising as a result of chemotherapy, radiation therapy, or a combination of these modalities given for a primary condition. The disease biology varies based on the etiology and treatment modalities patients receive for their primary condition. Topoisomerase II inhibitor therapy results in balanced translocations. Alkylating agents, characteristically, give rise to more complex karyotypes and mutations in p53. Other etiologies include radiation therapy, high-dose chemotherapy with autologous stem cell transplantation and telomere dysfunction. Poor-risk cytogenetic abnormalities are more prevalent than they are in de novo leukemias and the prognosis of these patients is uniformly dismal. Outcome varies according to cytogenetic risk group. Treatment recommendations should be based on performance status and karyotype. An in-depth understanding of risk factors that lead to the development of therapy-related myeloid neoplasms would help developing risk-adapted treatment protocols and monitoring patients after treatment for the primary condition, translating into reduced incidence, early detection and timely treatment.

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与治疗有关的骨髓瘤-到目前为止，我们学到了什么？

与治疗有关的骨髓瘤是由于化学疗法，放射疗法或针对主要疾病而提供的这些方式的组合而引起的肿瘤形成过程。疾病生物学根据患者针对其主要疾病所接受的病因和治疗方式而有所不同。拓扑异构酶II抑制剂治疗可导致平衡的易位。烷基化剂通常会在p53中引起更复杂的核型和突变。其他病因包括放射疗法，自体干细胞移植的大剂量化疗和端粒功能障碍。与新发白血病相比，低风险的细胞遗传学异常更为普遍，这些患者的预后普遍令人沮丧。结果因细胞遗传学风险组而异。治疗建议应基于表现状态和核型。深入了解导致与治疗有关的骨髓瘤发展的危险因素，将有助于制定适应风险的治疗方案，并在治疗后监测患者的主要病情，从而降低发病率，及早发现并及时治疗。