Ravandi Farhad, Kantarjian Hagop, Giles Francis, Cortes Jorge
Department of Leukemia, The University of Texas M D Anderson Cancer Center, Houston, Texas 77030, USA.
Cancer. 2004 Feb 1;100(3):441-54. doi: 10.1002/cncr.11935.
Over the past several decades, improvements in chemotherapeutic agents and supportive care have resulted in significant progress in treating patients with acute myeloid leukemia (AML). More recently, advances in understanding the biology of AML have resulted in the identification of new therapeutic targets. The success of all-trans-retinoic acid in acute promyelocytic leukemia and of imatinib mesylate in chronic myeloid leukemia have demonstrated that targeted therapy may be more effective and less toxic when well defined targets are available. At the same time, understanding mechanisms of drug resistance and means to overcome them has led to modification of some of the existing cytotoxic agents. Rational design and conduct of clinical trials is necessary to ensure that the full potential of these new agents is realized.
在过去几十年中,化疗药物和支持性治疗的改进使急性髓系白血病(AML)患者的治疗取得了显著进展。最近,对AML生物学的深入了解促使了新治疗靶点的发现。全反式维甲酸在急性早幼粒细胞白血病中的成功应用以及甲磺酸伊马替尼在慢性髓系白血病中的应用表明,当有明确的靶点时,靶向治疗可能更有效且毒性更小。同时,对耐药机制及克服方法的了解促使对一些现有的细胞毒性药物进行了改良。合理设计和开展临床试验对于确保这些新药物的全部潜力得以实现是必要的。