在极端年龄的急性原核细胞白血病的管理
Sabine Kayser1,2, Shannon E Conneely3
1Institute of Transfusion Medicine and Immunology, Medical Faculty Mannheim, Heidelberg University, 68167 Mannheim, Germany.
Cancers
|July 29, 2023
概括
全跨网红酸 (ATRA) 和三氧化 (ATO) 提供了治疗急性肌肉细胞白血病 (APL) 的方法. 本综述侧重于老年和儿科患者的APL治疗挑战,旨在改善治疗结果.
科学领域:
- 血液学 血液学 血液学
- 在瘤学瘤学.
- 临床治疗学 临床治疗学
背景情况:
- 急性前列细胞白血病 (APL) 治疗已经被全转网红酸 (ATRA) 和三氧化 (ATO) 彻底改变.
- ATO/ATRA是年轻,非高风险APL患者的标准第一线治疗,显著提高了生存率.
- 早期死亡仍然是APL的关键问题,特别是在老年人群中,强调了快速诊断和立即治疗的必要性.
研究的目的:
- 审查目前在老年和儿科患者群体中治疗急性肌肉细胞白血病 (APL) 的方法.
- 解决与APL管理相关的挑战,包括早期死亡,非标准患者组的治疗和毒性管理.
主要方法:
- 本综述综合了现有的临床知识,病例报告和注册数据.
- 它讨论了APL管理的治疗策略和支持性护理考虑.
- 重点放在适应特定患者人口统计的标准治疗.
主要成果:
- ATRA和ATO的结合使APL从致命的疾病转变为可治愈的疾病.
- 标准的ATO/ATRA疗法在年轻人中非常有效,但在老年患者中存在挑战.
- 在APL中管理毒性和并发症需要仔细考虑,特别是在脆弱的患者群体中.
结论:
- 尽管有进展,但APL的早期死亡,特别是老年人,需要及时诊断和治疗.
- 定制基于ATRA的疗法和支持性护理对于优化老年和儿科APL患者的治疗结果至关重要.
- 进一步的研究和病例报告/注册表的数据对于管理受控试验之外的具有挑战性的APL病例至关重要.
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