Mandelli F, Montefusco E
Dipartimento di Biotecnologie Cellulari ed Ematologia, Università La Sapienza, Roma.
Recenti Prog Med. 1999 Nov;90(11):605-12.
In the last decade the use of new drugs (retinoic acid, interferons, purine nucleoside analogs etc.) had only minimal impact in the evolution of leukemia management. In most cases, therapeutic options have progressed because of advances in supportive therapies and optimization of old chemotherapeutic strategies. Several experiences with autologous bone marrow transplantation (BMT) have proved that in acute leukemias and in selected patients with chronic leukemias is a valid alternative to allogeneic BMT. The availability of hematopoietic stem cells from unrelated donors and from cord blood, has overcome difficulties related to the absence of a suitable HLA identical sibling donor. Modern therapeutic approaches point to tailor treatment intensity according to risk categories, defined by clinical and biological parameters at diagnosis. In this context, the prognostic role of karyotypic lesions is under investigation.
在过去十年中，使用新药（维甲酸、干扰素、嘌呤核苷类似物等）对白血病治疗的进展影响甚微。在大多数情况下，治疗选择的进步得益于支持治疗的进展以及旧有化疗策略的优化。多项自体骨髓移植（BMT）经验已证明，对于急性白血病以及部分慢性白血病患者而言，自体骨髓移植是异基因BMT的有效替代方案。来自非亲属供者和脐血的造血干细胞的可得性，克服了因缺乏合适的 HLA 配型同胞供者而产生的困难。现代治疗方法旨在根据诊断时的临床和生物学参数所定义的风险类别来调整治疗强度。在此背景下，核型病变的预后作用正在研究之中。
