治疗相关的急性髓系白血病 (t-AML) 通常表现出不良（遗传）特征。关于 t-AML 对 AML 长期结果的影响的讨论正在进行中。因此，我们回顾性分析了 1133 例 AML 患者（225 例 t-AML 患者和 908 例新发 AML 患者）的临床和生物学特征，中位随访时间为 81.8 个月。与新发 AML 相比，T-AML 患者表现出更多不利的基因改变、更高的年龄和更多的合并症。接受强化治疗的 t-AML 患者的中位 OS 为 13.7 个月，而新发 AML 患者的中位 OS 为 39.4 个月 (p<0.001)。对于非强化治疗，OS 没有显着差异 (p = 0.394)。通过强化治疗，在 ELN 中间 I/II (p = 0.009) 和不良 (p = 0.016) 风险组中观察到有利于从头 AML 的显着差异，但在有利风险组 (APL p = 0.927，ELN 有利 p) 中没有观察到显着差异。 = 0.714）。然而，在多变量分析中，t-AML 并不是 OS (p = 0.103)、RR (p = 0.982) 和 NRM (p = 0.320) 的独立危险因素。我们研究的局限性是 ELN 2010 风险分层，因为根据 ELN 2022 缺乏更全面的分子数据。我们的结论是，t-AML 的治疗算法，特别是同种异体造血干细胞移植 (allo-HSCT)，应以 ELN 遗传为指导风险而不是单独分类为 t-AML。我们的数据支持 WHO 和 ICC 2022 分类，其中包括 t-AML 作为诊断限定符，而不是单独的子类别。© 2024。作者。

Therapy-related acute myeloid leukemia (t-AML) often exhibits adverse (genetic) features. There is ongoing discussion on the impact of t-AML on long-term outcome in AML. Therefore, we retrospectively analyzed clinical and biological characteristics of 1133 AML patients (225 t-AML patients and 908 de novo AML patients) with a median follow-up of 81.8 months. T-AML patients showed more adverse genetic alterations, higher age and more comorbidities as compared to de novo AML. Median OS in intensively treated t-AML patients was 13.7 months as compared to 39.4 months in de novo AML (p < 0.001). With non-intensive therapy, OS did not differ significantly (p = 0.394). With intensive therapy, significant differences in favor of de novo AML were observed in the ELN intermediate I/II (p = 0.009) and adverse (p = 0.016) risk groups but not within favorable risk groups (APL p = 0.927, ELN favorable p = 0.714). However, t-AML was no independent risk factor for OS (p = 0.103), RR (p = 0.982) and NRM (p = 0.320) in the multivariate analysis. A limitation of our study is an ELN 2010 risk stratification due to a lack of more comprehensive molecular data according to ELN 2022. We conclude that therapeutic algorithms in t-AML, in particular with regard to allo-HSCT, should be guided by ELN genetic risk rather than classification as t-AML alone. Our data support the WHO and ICC 2022 classifications, which include t-AML as diagnostic qualifier rather than a separate subcategory.© 2024. The Author(s).