Journal of Internal Medicine Concepts & Practice >

2026 , Vol. 21 >Issue 02: 199 - 204

DOI: https://doi.org/10.16138/j.1673-6087.2026.02.16

Research progress on the pathogenesis and clinical features of secondary acute myeloid leukemia

  • GAO Mingmin ,
  • WU Tao ,
  • LIU Wenhui
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  • Department of Hematology, the 940th Hospital of Joint Logistics Support Force of the People's Liberation Army of China, Lanzhou 730050, China

Received date: 2025-05-08

  Revised date: 2025-07-31

  Accepted date: 2025-08-12

  Online published: 2026-06-15

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Copyright © 2026 Journal of Internal Medicine Concepts & Practice. All rights reserved.
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Abstract

Secondary acute myeloid leukemia (sAML) refers to AML that occurs on the basis of a pre-existing hematological disease, or in patients with previous solid tumors who have undergone chemotherapy or radiotherapy. Compared with primary AML, the incidence of this type of disease is lower, but its pathogenesis is complex, and the overall survival of patients is shorter. Therefore, in-depth research on the pathogenesis and clinical features of sAML has important clinical significance.

Key words： secondary acute myeloid leukemia; clinical features; treatment; prognosis

Cite this article

GAO Mingmin , WU Tao , LIU Wenhui . Research progress on the pathogenesis and clinical features of secondary acute myeloid leukemia[J]. Journal of Internal Medicine Concepts & Practice, 2026 , 21(02) : 199 -204 . DOI: 10.16138/j.1673-6087.2026.02.16

References

[1] 秦嘉琦, 程骁赪, 周越, 等. 继发性急性髓系白血病的研究进展[J]. 临床血液学杂志,2025,38(3):247-251.
  Qin JQ, Cheng XC, Zhou Y, et al. Advances of secondary acute myeloid leukemia[J]. J Clin Hematol,2025,38(3):247-251.
[2] Martínez-Cuadrón D, Megías-Vericat JE, Serrano J, et al. Treatment patterns and outcomes of 2310 patients with secondary acute myeloid leukemia: a PETHEMA registry study[J]. Blood Adv,2022,6(4):1278-1295.
[3] 董悦昕. 继发性急性髓系白血病和粒细胞缺乏性发热的临床分析[D]. 上海: 上海交通大学, 2020.
  Dong YX. Clinical study of secondary acute myeloid leukemia and febrile neutropenia[D]. Shanghai:Shanghai Jiao Tong University, 2020.
[4] Huleg?rdh E, Nilsson C, Lazarevic V, et al. Characterization and prognostic features of secondary acute myeloid leukemia in a population-based setting: a report from the Swedish Acute Leukemia Registry[J]. Am J Hematol,2015,90(3):208-214.
[5] Matthews A, Pratz KW. Optimizing outcomes in secondary AML[J]. Hematology Am Soc Hematol Educ Program,2022,2022(1):23-29.
[6] 张梦露, 陈婉淑, 韩冰. 获得性再生障碍性贫血体细胞突变及其意义[J]. 中国医学科学院学报,2022,44(3):491-496.
  Zhang ML, Chen WS, Han B. Somatic mutations of acquired aplastic anemia[J]. Acta Acad Med Sin,2022,44(3):491-496.
[7] 羊文莉, 佟红艳. p53在5q-综合征发病机制中的研究现状[J]. 国际输血及血液学杂志,2021,44(1):7-13.
  Yang WL, Tong HY. Research status of p53 in the pathogenesis of 5q-syndrome[J]. Int J Blood Transfus Hematol,2021,44(1):7-13.
[8] Spinella JF, Chagraoui J, Moison C, et al. DELE1 haploinsufficiency causes resistance to mitochondrial stress-induced apoptosis in monosomy 5/del(5q) AML[J]. Leukemia,2024,38(3):530-537.
[9] Dou X, Dan C, Zhang D, et al. Genomic mutation patterns and prognostic value in de novo and secondary acute myeloid leukemia: a multicenter study from China[J]. Int J Cancer,2024,155(12):2253-2264.
[10] Puzo CJ, Hager KM, Rinder HM, et al. Overall survival in TP53-mutated AML and MDS[J]. Ann Hematol,2024,103(12):5359-5369.
[11] 马玲, 赵婷, 陈育红, 等. 继发性急性髓系白血病的治疗反应和结局及其影响因素分析[J]. 中华血液学杂志,2023,44(2):124-131.
  Ma L, Zhao T, Chen YH, et al. Treatment responses, outcomes, and prognostic factors associated with them in patients with secondary acute myeloid leukemia[J]. Chin J Hematol,2023,44(2):124-131.
[12] 周佳玮, 吴涛, 刘文慧. 急性髓系白血病中DNMT3A基因表达的研究进展[J]. 中华医学遗传学杂志,2024,41(8):1010-1015.
  Zhou JW, Wu T, Liu WH. Research progress on DNMT3A gene expression in acute myeloid leukemia[J]. Chin J Med Genet,2024,41(8):1010-1015.
[13] Makishima H, Yoshizato T, Yoshida K, et al. Dynamics of clonal evolution in myelodysplastic syndromes[J]. Nat Genet,2017,49(2):204-212.
[14] Chan SM, Majeti R. Role of DNMT3A, TET2, and IDH1/2 mutations in pre-leukemic stem cells in acute myeloid leukemia[J]. Int J Hematol,2013,98(6):648-657.
[15] 安慧慧, 吴涛, 李芸芸, 等. CEBPA双突变合并GATA2种系突变急性髓系白血病1例[J]. 内科理论与实践,2024,19(3):185-187.
  An Huihui, Wu Tao, Li Yunyun, et al. Acute myeloid leukemia with CEBPA double mutation combined with GATA2 germline mutation: one case report[J]. J Intern Med Concepts Pract,2024,19(3):185-187.
[16] Inoue S, Lemonnier F, Mak TW. Roles of IDH1/2 and TET2 mutations in myeloid disorders[J]. Int J Hematol,2016,103(6):627-633.
[17] Ponciano-Gómez A, Martínez-Tovar A, Vela-Ojeda J, et al. Mutations in TET2 and DNMT3A genes are associated with changes in global and gene-specific methylation in acute myeloid leukemia[J]. Tumour Biol,2017,39(10):1010428317732181.
[18] Pimenta DB, Varela VA, Datoguia TS, et al. The bone marrow microenvironment mechanisms in acute myeloid leukemia[J]. Front Cell Dev Biol,2021,9:764698.
[19] 庞静玲, 吴涛, 白海. 治疗相关性白血病的研究进展[J]. 中国医刊,2017,52(12):36-39.
  Pang JL, Wu T, Bai H. Research progress on therapy-related leukemia[J]. Chin J Med,2017,52(12):36-39.
[20] Green SD, Wang ES. How I treat secondary acute myeloid leukemia[J]. Blood,2025,145(12):1260-1272.
[21] Shahin OA, Chifotides HT, Bose P, et al. Accelerated phase of myeloproliferative neoplasms[J]. Acta Haematol,2021,144(5):484-499.
[22] 李文凤, 周靖博, 赵艳红, 等. 复发难治性急性髓系白血病治疗现状及新药进展[J]. 中国实验血液学杂志,2022,30(6):1907-1911.
  Li WF, Zhou JB, Zhao YH, et al. Current status and new drugs progress in the treatment of relapsed and refractory acute myeloid leukemia — review[J]. J Exp Hematol,2022,30(6):1907-1911.
[23] Batra A, Sparks A, Singh R, et al. Characteristics and survival of secondary acute myeloid leukemia from myelodysplastic syndromes in older adults: a population analysis[J]. Clin Lymphoma Myeloma Leuk,2025,25(6):e417-e423.
[24] Gupta V, Kim S, Hu ZH, et al. Comparison of outcomes of HCT in blast phase of BCR-ABL1 ? MPN with de novo AML and with AML following MDS[J]. Blood Adv,2020,4(19):4748-4757.
[25] McKinnell Z, Karel D, Tuerff D, et al. Acute myeloid leukemia following myeloproliferative neoplasms: a review of what we know, what we do not know, and emerging treatment strategies[J]. J Hematol,2022,11(6):197-209.
[26] 洪世红. 继发性急性髓系白血病临床特点及相关分析[D]. 南昌: 南昌大学, 2023.
  Hong SH. Clinical characteristics and correlation analysis of secondary acute myeloid leukemia[D]. Nanchang:Nanchang University, 2023.
[27] Begna KH, Ali W, Gangat N, et al. Mayo Clinic experience with 1123 adults with acute myeloid leukemia[J]. Blood Cancer J,2021,11(3):46.
[28] 王飘. 继发性急性髓系白血病的临床特点及预后分析[D]. 长春: 吉林大学, 2024.
  Wang P. Clinical features and prognosis of secondary acute myeloid leukemia[D]. Changchun:Jilin University, 2024.
[29] Granfeldt ?stg?rd LS, Medeiros BC, Sengel?v H, et al. Epidemiology and clinical significance of secondary and therapy-related acute myeloid leukemia: a national population-based cohort study[J]. J Clin Oncol,2015,33(31):3641-3649.
[30] 刘霞霞, 文晓玲, 黎若祺, 等. 维奈克拉联合阿扎胞苷与“7+3”方案在新诊断老年急性髓系白血病中近期疗效的初步观察[J]. 中国实验血液学杂志,2024,32(1):96-103.
  Liu XX, Wen XL, Li RQ, et al. Short-term effect of venetoclax combined with azacitidine and “7+3” regimen in the treatment of newly diagnosed elder patients with acute myeloid leukemia[J]. J Exp Hematol,2024,32(1):96-103.
[31] Song BQ, Kong X, Liu Y, et al. Efficacy of venetoclax combined with homoharringtonine and cytarabine for younger adults with newly diagnosed AML[J]. Ann Hematol,2025,104(3):1617-1622.
[32] Lancet JE, Uy GL, Cortes JE, et al. CPX-351 (cytarabine and daunorubicin) liposome for injection versus conventional cytarabine plus daunorubicin in older patients with newly diagnosed secondary acute myeloid leukemia[J]. J Clin Oncol,2018,36(26):2684-2692.
[33] 申恒, 魏辉, 谈家齐. CPX-351对比“7+3”化疗在初诊高危或继发性急性髓系白血病老年患者中的5年随访结果[J]. 循证医学,2022,22(2):84-86.
  Shen H, Wei H, Tan JQ. 5-year follow-up results of CPX-351 versus 7+3 chemotherapy in older adults with newly diagnosed high- risk or secondary acute myeloid leukemia[J]. J Evid-Based Med,2022,22(2):84-86.
[34] 吴沂璇, 段永娟, 蔡玉丽, 等. 急性B淋巴细胞白血病BCL-2抑制剂耐药细胞系的构建及耐药机制研究[J]. 中国实验血液学杂志,2024,32(5):1305-1312.
  Wu YX, Duan YJ, Cai YL, et al. Establishment of BCL-2 inhibitors-resistant B-cell acute lymphoblastic leukemia cell lines and study on their resistance mechanisms[J]. J Exp Hematol,2024,32(5):1305-1312.
[35] Wei AH, Roberts AW. BCL2 inhibition: a new paradigm for the treatment of AML and beyond[J]. Hemasphere,2023,7(6):e912.
[36] 张苗. 地西他滨通过去甲基化调节肝癌细胞对索拉非尼的耐药性[D]. 合肥: 安徽医科大学, 2023.
  Zhang M. Mechanism of decitabine regulating sorafenib resistance in hepatocellular carcinoma cells through demethylation[D]. Hefei:Anhui Medical University, 2023.
[37] de Castro FA, Mehdipour P, Chakravarthy A, et al. Ratio of stemness to interferon signalling as a biomarker and therapeutic target of myeloproliferative neoplasm progression to acute myeloid leukemia[J]. Br J Haematol,2024,204(1):206-220.
[38] Roboz GJ, Mandrekar SJ, Desai P, et al. Randomized trial of 10 days of decitabine bortezomib in untreated older patients with AML: CALGB 11002 (Alliance)[J]. Blood Adv,2018,2(24):3608-3617.
[39] Schieber M, Marinaccio C, Bolanos LC, et al. FBXO11 is a candidate tumor suppressor in the leukemic transformation of myelodysplastic syndrome[J]. Blood Cancer J,2020,10(10):98.
[40] Auerbach S, Puka B, Golla U, et al. Recent advances towards the understanding of secondary acute myeloid leukemia progression[J]. Life (Basel),2024,14(3):309.
[41] Salhotra A, Aribi A, Ngo D, et al. Outcome of secondary acute myeloid leukemia treated with hypomethylating agent plus venetoclax (HMA-Ven) or liposomal daunorubicin-cytarabine (CPX-351)[J]. Am J Hematol,2021,96(6):E196-E200.
[42] Nilsson C, Huleg?rdh E, Garelius H, et al. Secondary acute myeloid leukemia and the role of allogeneic stem cell transplantation in a population-based setting[J]. Biol Blood Marrow Transplant,2019,25(9):1770-1778.
[43] Strickland SA, Vey N. Diagnosis and treatment of therapy-related acute myeloid leukemia[J]. Crit Rev Oncol Hematol,2022,171:103607.
[44] Guolo F, Fianchi L, Minetto P, et al. CPX-351 treatment in secondary acute myeloblastic leukemia is effective and improves the feasibility of allogeneic stem cell transplantation: results of the Italian compassionate use program[J]. Blood Cancer J,2020,10(10):96.
[45] 裴坤林. CLL1 CAR-T细胞治疗儿童难治/复发性急性髓系白血病的基础与临床研究[D]. 广州: 广州医科大学, 2023.
  Pei KL. Role of CLL1 CAR T-cells in children with refractory/relapsed acute myeloid leukemia[D]. Guangzhou:Guangzhou Medical University, 2023.
[46] Khalifeh M, Hopewell E, Salman H. CAR-T cell therapy for treatment of acute myeloid leukemia, advances and outcomes[J]. Mol Ther,2025,33(6):2441-2453.
[47] Limongello R, Marra A, Mancusi A, et al. Novel immune cell-based therapies to eradicate high-risk acute myeloid leukemia[J]. Front Immunol,2021,12:695051.
[48] Zhang H, Gan WT, Hao WG, et al. Successful anti-CLL1 CAR T-cell therapy in secondary acute myeloid leukemia[J]. Front Oncol,2020,10:685.
[49] McNerney ME, Godley LA, Le Beau MM. Therapy-related myeloid neoplasms: when genetics and environment collide[J]. Nat Rev Cancer,2017,17(9):513-527.
[50] 姜艳红, 王浩, 毕利军, 等. 不同类型继发性急性髓系白血病患者临床和实验室特点的对比分析[J]. 现代肿瘤医学,2023,31(15):2884-2890.
  Jiang YH, Wang H, Bi LJ, et al. Comparative analysis of clinical and laboratory characteristics of patients with different types of secondary acute myeloid leukemia[J]. J Mod Oncol,2023,31(15):2884-2890.
[51] 庞静玲, 吴涛, 蔡永刚, 等. 卵巢癌化疗后继发急性髓系白血病1例[J]. 肿瘤学杂志,2017,23(9):832-833.
  Pang JL, Wu T, Cai YG, et al. Secondary acute myelogenous leukemia in a patient with ovarian cancer after chemotherapy[J]. Journal of Chinese Oncology,2017,23(9):832-833.
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