成年人急性髓性白血病中的急性髓性白血病
Felicetto Ferrara1, Charles A Schiffer
1Division of Haematology and Stem Cell Transplantation Unit, Naples, Italy. felicettoferrara@katamail.com
Lancet (London, England)
|February 13, 2013
概括
支持性护理的进步改善了急性髓性白血病 (AML) 的结果,但针对分子异常的新疗法至关重要. 克服治疗耐药性和复发仍然是治疗AML的关键.
科学领域:
- 血液学 血液学 血液学
- 在瘤学瘤学.
- 内部医学 内部医学
背景情况:
- 30年来急性髓性白血病 (AML) 治疗的显著进展主要是由于改善了支持性护理.
- 支持措施,如新的抗微生物和抗药剂,以及加强输血支持,已经减少了早期死亡率.
- 降低来自全原干细胞移植的发病率和死亡率也为改善患者前景做出了贡献.
研究的目的:
- 突出治疗急性髓性白血病 (AML) 的持续挑战,特别是折射性和复发性.
- 强调需要超越传统化疗的新型治疗策略.
- 要强调转向基于对AML分子病原学的更深入理解的向治疗的转变.
主要方法:
- 关于急性髓性白血病 (AML) 支持性护理进展的审查.
- 分析AML治愈目前的障碍,包括治疗耐药性和复发.
- 检查新兴的研究趋势,重点关注分子向剂.
主要成果:
- 支持性护理的改进降低了早期死亡率和移植并发症.
- 尽管有进展,但超过一半的年轻成年人和90%的老年AML患者仍然死于这种疾病.
- 对诱导疗法的抗拒性和缓解后复发仍然是治愈的重大障碍.
结论:
- 具有独特作用机制的新型治疗方法对于克服AML治疗耐药性和复发至关重要.
- 针对诊断时发现的特定分子异常,结合化疗,是有前途的研究方向.
- 在AML亚克隆中存在多个同时存在的异常,需要组合疗法来有效抑制疾病.
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