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style=\"font-size: 15px;\">急性髓系白血病（AML）是一组血液和骨髓的恶性肿瘤。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp>\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Cp>\u003Cspan style=\"font-size: 15px;\">骨髓是骨骼内的海绵状组织，是血细胞生成的场所。急性髓系白血病中的“急性”指的是疾病进展迅速。之所以被称为“髓系白血病”，是因为它累及的是髓性白细胞，在正常情况下这类细胞可以发育为各种类型的成熟血细胞，例如红细胞、白细胞和血小板。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp>\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Cp>\u003Cspan style=\"font-size: 15px;\">急性髓系白血病又称急性髓性白血病、急性髓母细胞白血病、急性粒细胞白血病和急性非淋巴细胞白血病。\u003C\u002Fspan>\u003C\u002Fp>","⚕️","2026-09-14",{"key":90,"title":91,"html":92,"icon":93,"updatedAt":88},"cause","病因","\u003Cp>\u003Cspan style=\"font-size: 15px;\">急性髓系白血病是由骨髓中正在发育的细胞的DNA出现损伤所致。当DNA出现损伤时，血细胞的生成会出现错误。骨髓产生的不成熟细胞形成白血病细胞，称为原始粒细胞。这些异常细胞无法正常发挥功能，会逐渐堆积并排挤掉正常细胞。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp>\u003Cbr\u002F>\u003C\u002Fp>\u003Cp>\u003Cspan style=\"font-size: 15px;\">在大多数病例中，导致DNA突变引起白血病的原因尚不清楚。辐射、暴露于某些化学物质以及一些化疗药物是急性髓系白血病已知的危险因素。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp>\u003Cbr\u002F>\u003C\u002Fp>","🧬",{"key":95,"title":96,"html":97,"icon":98,"updatedAt":88},"symptom","症状表现","\u003Cp>\u003Cspan style=\"font-size: 15px;\">急性髓系白血病的早期症状和体征通常与流感或其他常见疾病类似。根据受累血细胞的类型不同，症状和体征也存在差异。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp>\u003Cbr\u002F>\u003C\u002Fp>\u003Cp>\u003Cspan style=\"font-size: 15px;\">\u003Cstrong>急性髓系白血病的症状和体征包括：\u003C\u002Fstrong>\u003C\u002Fspan>\u003C\u002Fp>\u003Cul class=\" list-paddingleft-2\" style=\"list-style-type: disc;\">\u003Cli>\u003Cp>\u003Cspan style=\"font-size: 15px;\">发热\u003C\u002Fspan>\u003C\u002Fp>\u003C\u002Fli>\u003Cli>\u003Cp>\u003Cspan style=\"font-size: 15px;\">骨痛\u003C\u002Fspan>\u003C\u002Fp>\u003C\u002Fli>\u003Cli>\u003Cp>\u003Cspan style=\"font-size: 15px;\">嗜睡和疲劳\u003C\u002Fspan>\u003C\u002Fp>\u003C\u002Fli>\u003Cli>\u003Cp>\u003Cspan style=\"font-size: 15px;\">气短\u003C\u002Fspan>\u003C\u002Fp>\u003C\u002Fli>\u003Cli>\u003Cp>\u003Cspan style=\"font-size: 15px;\">皮肤苍白\u003C\u002Fspan>\u003C\u002Fp>\u003C\u002Fli>\u003Cli>\u003Cp>\u003Cspan style=\"font-size: 15px;\">频繁感染\u003C\u002Fspan>\u003C\u002Fp>\u003C\u002Fli>\u003Cli>\u003Cp>\u003Cspan style=\"font-size: 15px;\">易出现瘀青\u003C\u002Fspan>\u003C\u002Fp>\u003C\u002Fli>\u003Cli>\u003Cp>\u003Cspan style=\"font-size: 15px;\">异常出血，例如频繁的鼻出血和牙龈出血\u003C\u002Fspan>\u003C\u002Fp>\u003C\u002Fli>\u003C\u002Ful>","📋",{"key":100,"title":101,"html":102,"icon":103,"updatedAt":88},"exam","诊断检查","\u003Cp>\u003Cspan style=\"font-size: 15px;\">如果您有急性髓系白血病的症状和体征，医生会建议您接受诊断性检查，包括：\u003C\u002Fspan>\u003C\u002Fp>\u003Cp>\u003Cbr\u002F>\u003C\u002Fp>\u003Ch3>\u003Cspan style=\"font-size: 15px;\">\u003Cstrong>血液检查 \u003C\u002Fstrong>\u003C\u002Fspan>\u003C\u002Fh3>\u003Cp>\u003Cspan style=\"font-size: 15px;\">大多数急性髓系白血病患者白细胞数量过多，而红细胞和血小板数量不足。\u003C\u002Fspan>\u003Cspan style=\"font-size: 15px;\">原始细胞的出现也提示急性髓系白血病，正常情况下，这类不成熟的细胞只存在于骨髓中，而不是外周血中。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp>\u003Cbr\u002F>\u003C\u002Fp>\u003Ch3>\u003Cspan style=\"font-size: 15px;\">\u003Cstrong>骨髓检查\u003C\u002Fstrong>\u003C\u002Fspan>\u003C\u002Fh3>\u003Cp>\u003Cspan style=\"font-size: 15px;\">血液检查可提示白血病，但通常需要进行骨髓检查才能确诊。\u003C\u002Fspan>\u003Cspan style=\"font-size: 15px;\">进行骨髓穿刺时，医生会用一根穿刺针抽取骨髓标本。通常是从髋骨部位（髂后上棘）取骨髓标本。这些标本会被送至实验室进行检查。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp>\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Ch3>\u003Cspan style=\"font-size: 15px;\">\u003Cstrong>腰椎穿刺\u003C\u002Fstrong>\u003C\u002Fspan>\u003C\u002Fh3>\u003Cp>\u003Cspan style=\"font-size: 15px;\">在一些情况下，需要抽取少量脑脊液标本检查有无白血病细胞。医生会将一根细的穿刺针从腰椎处插入椎管来采集脑脊液标本。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp>\u003Cbr\u002F>\u003C\u002Fp>\u003Ch3>\u003Cspan style=\"font-size: 15px;\">\u003Cstrong>基因检测\u003C\u002Fstrong>\u003C\u002Fspan>\u003C\u002Fh3>\u003Cp>\u003Cspan style=\"font-size: 15px;\">针对白血病细胞的实验室检查可以明确其特异性的基因、染色体改变和其他独有的问题，同时还能发现基因方面的改变或突变。这种检测有助于判断您的预后并指导治疗。\u003C\u002Fspan>\u003C\u002Fp>","🩺",{"key":105,"title":106,"html":107,"icon":108,"updatedAt":88},"treatment","治疗方式","\u003Cp>\u003Cspan style=\"font-size: 15px;\">急性髓系白血病的治疗取决于许多因素，包括疾病亚型，患者年龄、整体健康状况和个人意愿。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp>\u003Cbr\u002F>\u003C\u002Fp>\u003Cp>\u003Cspan style=\"font-size: 15px;\">一般来说，治疗分为两个阶段：\u003C\u002Fspan>\u003C\u002Fp>\u003Cp>\u003Cbr\u002F>\u003C\u002Fp>\u003Ch3>\u003Cspan style=\"font-size: 15px;\">\u003Cstrong>诱导缓解治疗 \u003C\u002Fstrong>\u003C\u002Fspan>\u003C\u002Fh3>\u003Cp>\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>第一阶段治疗的目的是杀灭血液和骨髓中的白血病细胞。然而，诱导缓解治疗通常不能清除所有的白血病细胞，所以您需要进一步治疗来预防疾病复发。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp>\u003Cbr\u002F>\u003C\u002Fp>\u003Ch3>\u003Cspan style=\"font-size: 15px;\">\u003Cstrong>巩固治疗 \u003C\u002Fstrong>\u003C\u002Fspan>\u003C\u002Fh3>\u003Cp>\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>巩固治疗又称缓解后治疗、维持治疗或强化治疗，这一阶段的治疗目标是破坏体内残留的白血病细胞。这对降低复发风险至关重要。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp>\u003Cbr\u002F>\u003C\u002Fp>\u003Ch2>\u003Cspan style=\"font-size: 15px;\">\u003Cstrong>化疗\u003C\u002Fstrong>\u003C\u002Fspan>\u003C\u002Fh2>\u003Cp>\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>化疗是诱导缓解治疗的主要方法，也可用于巩固治疗。化疗使用化学药物杀灭体内的恶性肿瘤细胞。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp>\u003Cspan style=\"font-size: 15px;\">化疗期间，因为药物在杀灭白血病细胞的同时会破坏许多正常细胞，所以急性髓系白血病患者通常需要住院。如果第一轮化疗未能缓解，可以重复治疗。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp>\u003Cbr\u002F>\u003C\u002Fp>\u003Ch2>\u003Cspan style=\"font-size: 15px;\">\u003Cstrong>靶向治疗\u003C\u002Fstrong>\u003C\u002Fspan>\u003C\u002Fh2>\u003Cp>\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>靶向治疗使用药物攻击肿瘤细胞的特异性缺陷。Midostaurin（Rydapt）能够阻断白血病细胞内一种酶的作用，导致细胞死亡。Midostaurin只对肿瘤细胞中存在FLT3突变的患者有效。药物为口服片剂。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp>\u003Cbr\u002F>\u003C\u002Fp>\u003Ch2>\u003Cspan style=\"font-size: 15px;\">\u003Cstrong>其他药物治疗 \u003C\u002Fstrong>\u003C\u002Fspan>\u003C\u002Fh2>\u003Cp>\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>三氧化二砷（Trisenox）和全反式维甲酸（ATRA）是可以单独使用或与化疗联合使用的抗肿瘤药物，可用于AML特定亚型（早幼粒细胞性白血病）的诱导缓解治疗。这些药物可诱导具有特异性基因突变的白血病细胞成熟和死亡，或停止分裂。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp>\u003Cbr\u002F>\u003C\u002Fp>\u003Ch2>\u003Cspan style=\"font-size: 15px;\">\u003Cstrong>造血干细胞移植\u003C\u002Fstrong>\u003C\u002Fspan>\u003C\u002Fh2>\u003Cp>\u003Cspan style=\"font-size: 15px;\">\u003Cstrong>\u003Cbr\u002F>\u003C\u002Fstrong>\u003C\u002Fspan>\u003C\u002Fp>\u003Cp>\u003Cspan style=\"font-size: 15px;\">骨髓移植又称干细胞移植，可用于巩固治疗。骨髓移植是用可再生为正常骨髓的无白血病干细胞替换白血病患者不正常的骨髓，以帮助重新生成正常的干细胞。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp>\u003Cbr\u002F>\u003C\u002Fp>\u003Cp>\u003Cspan style=\"font-size: 15px;\">在进行骨髓移植之前，您会接受非常大剂量的化疗或放疗，以破坏产生白血病细胞的骨髓。然后，您会接受来自相合供者的干细胞输注（异基因移植）。\u003C\u002Fspan>\u003Cspan style=\"font-size: 15px;\">如果您之前达到白血病缓解，而且采集并储存了自体健康的干细胞用于将来的移植，您也可以接受自身干细胞回输（自体移植）。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp>\u003Cbr\u002F>\u003C\u002Fp>","💊",{"author":110,"reviewedBy":110,"lastReviewed":110,"datePublished":110,"citations":111,"disclaimer":110},"",[112,115,118,121],{"title":113,"url":114},"National Cancer Institute (NCI). Acute Myeloid Leukemia Treatment (PDQ®)–Patient Version.","https:\u002F\u002Fwww.cancer.gov\u002Ftypes\u002Fleukemia\u002Fpatient\u002Fadult-aml-treatment-pdq ",{"title":116,"url":117},"National Cancer Institute (NCI). Acute Myeloid Leukemia Treatment (PDQ®)–Health Professional Version.","https:\u002F\u002Fwww.cancer.gov\u002Ftypes\u002Fleukemia\u002Fhp\u002Fadult-aml-treatment-pdq ",{"title":119,"url":120},"National Cancer Institute (NCI). Childhood Acute Myeloid Leukemia\u002FOther Myeloid Malignancies Treatment (PDQ®)–Patient Version.","https:\u002F\u002Fwww.cancer.gov\u002Ftypes\u002Fleukemia\u002Fpatient\u002Fchild-aml-treatment-pdq ",{"title":122,"url":123},"National Cancer Institute (NCI). Childhood Acute Myeloid Leukemia Treatment (PDQ®)–Health Professional Version.","https:\u002F\u002Fwww.cancer.gov\u002Ftypes\u002Fleukemia\u002Fhp\u002Fchild-aml-treatment-pdq",false,1789384105983]