Litzow Mark R
Division of Hematology, Mayo Clinic and Mayo Medical School, 200 First Streeet, SW, Rochester, MN 55905, USA.
Blood Rev. 2004 Mar;18(1):39-63. doi: 10.1016/s0268-960x(03)00036-5.
Although the cure of acute leukaemia has improved significantly, many patients will still relapse and die. The unraveling of the molecular pathogenesis of acute leukaemia has lead to the identification of new prognostic factors and improved the detection of minimal residual disease. The treatment of relapsed acute leukaemia with chemotherapy remains unsatisfactory. Allogeneic or autologous blood and marrow transplant (BMT) can cure a subset of patients with relapsed acute leukaemia. The identification of the graft-vs-leukaemia (GVL) effect has lead to the development of donor lymphocyte infusions to re-induce remission in patients with relapsed leukaemia after allogeneic BMT and also stimulated the development of the less toxic nonmyeloablative allogeneic transplant approach. The identification of molecular targets of therapy and the development of monoclonal antibody-directed therapy has generated optimism. It is possible that combinations of chemotherapy, molecularly directed therapy, and immunotherapy may be combined to cure an increasing proportion of patients with acute leukaemia.
尽管急性白血病的治愈率已有显著提高，但仍有许多患者会复发并死亡。急性白血病分子发病机制的阐明导致了新的预后因素的确定，并改善了微小残留病的检测。用化疗治疗复发的急性白血病仍然不能令人满意。异基因或自体血液和骨髓移植（BMT）可以治愈一部分复发的急性白血病患者。移植物抗白血病（GVL）效应的发现导致了供体淋巴细胞输注的发展，以在异基因BMT后使复发白血病患者重新诱导缓解，也刺激了毒性较小的非清髓性异基因移植方法的发展。治疗分子靶点的确定和单克隆抗体导向治疗的发展带来了希望。化疗、分子导向治疗和免疫治疗的联合应用有可能治愈越来越多的急性白血病患者。
