Craddock Charles, Tauro Sudhir, Moss Paul, Grimwade David
Leukaemia Unit, Department of Haematology, Queen Elizabeth Hospital, Birmingham, UK.
Br J Haematol. 2005 Apr;129(1):18-34. doi: 10.1111/j.1365-2141.2004.05318.x.
Disease relapse remains the major cause of treatment failure in adults with acute myeloid leukaemia (AML). This reflects both the failure of current salvage regimens and the absence of effective strategies to secure long-term disease-free survival in those patients who achieve a second remission. Recent progress in understanding the pathogenesis of relapsed disease has enabled the identification of a variety of dysregulated molecular pathways and these now provide a rational basis for the design of novel targeted therapies. At the same time, advances in allogeneic stem-cell transplantation have permitted the extension of the curative potential of allografting to patients in whom it was previously contraindicated. As a result, a range of novel drug and transplant therapies has become available in patients with relapsed AML, and it is realistic to anticipate that a co-ordinated assessment of their clinical and biological impact will provide the basis for the design of future, more effective treatments in relapsed disease.
疾病复发仍然是成人急性髓系白血病（AML）治疗失败的主要原因。这既反映了当前挽救治疗方案的失败，也反映了在那些获得第二次缓解的患者中缺乏确保长期无病生存的有效策略。在理解复发疾病发病机制方面的最新进展使得能够识别多种失调的分子途径，这些途径现在为设计新型靶向治疗提供了合理依据。与此同时，异基因干细胞移植的进展使得同种异体移植的治愈潜力能够扩展到以前被视为禁忌的患者。因此，一系列新型药物和移植疗法已应用于复发AML患者，预计对其临床和生物学影响进行协调评估将为设计未来更有效的复发疾病治疗方案提供依据。
