治疗相关性骨髓瘤 (t-MN) 是在有记录的化疗/放疗史作为治疗不相关病症的治疗后出现的，占骨髓增生异常综合征和急性髓性白血病的 10-20%。 T-MN 的特点是具有特定的遗传特征、侵袭性特征和糟糕的预后。这些疾病的命名法和子集随着时间的推移经常发生变化，尽管事实上，在最后的分类中，它们失去了自主实体状态并成为疾病限定词，但对这一特征的认识仍然非常重要。此外，近年来，针对克隆造血和种系变异的广泛研究揭示了支撑 t-MN 驱动基因突变增加的正压机制。在这篇手稿中，我们旨在从临床和生物学角度回顾 t-MN 定义标准和特征的演变、恶性进展机制方面的进展以及预防和管理方面的挑战。

Therapy-related myeloid neoplasms (t-MN) arise after a documented history of chemo/radiotherapy as treatment for an unrelated condition and account for 10-20% of myelodysplastic syndromes and acute myeloid leukemia. T-MN are characterized by a specific genetic signature, aggressive features and dismal prognosis. The nomenclature and the subsets of these conditions have changed frequently over time, and despite the fact that, in the last classification, they lost their autonomous entity status and became disease qualifiers, the recognition of this feature remains of major importance. Furthermore, in recent years, extensive studies focusing on clonal hematopoiesis and germline variants shed light on the mechanisms of positive pressure underpinning the rise of driver gene mutations in t-MN. In this manuscript, we aim to review the evolution of defining criteria and characteristics of t-MN from a clinical and biological perspective, the advances in mechanistic aspects of malignant progression and the challenges in prevention and management.