Ozawa Keiya
Division of Hematology, Department of Medicine, Jichi Medical University.
Nihon Rinsho. 2009 Oct;67(10):1841-6.
The fundamental principle of the treatment of AML (acute myeloid leukemia) is "total cell kill. " For remission induction, "response-oriented individualized therapy" was developed in Japan. However, the similar response rate was obtained by "set therapy," which became the present standard regimen. Regarding the post-remission therapy, consolidation therapy is conducted without further long-term maintenance/intensification therapy. For poor-risk patients, hematopoietic stem cell transplantation should be considered. To improve the therapeutic efficacy, the development of molecular targeted therapy will be indispensable. As for CML (chronic myeloid leukemia), the development of imatinib has completely changed the treatment strategy. The eradication of CML stem cells is the next challenging issue.
急性髓系白血病(AML)治疗的基本原则是“全细胞杀灭”。在日本,为诱导缓解开发了“以反应为导向的个体化治疗”。然而,通过“固定方案治疗”也获得了相似的缓解率,该方案成为了目前的标准治疗方案。关于缓解后治疗,进行巩固治疗,无需进一步的长期维持/强化治疗。对于高危患者,应考虑进行造血干细胞移植。为提高治疗效果,分子靶向治疗的发展将必不可少。至于慢性髓系白血病(CML),伊马替尼的出现彻底改变了治疗策略。根除CML干细胞是下一个具有挑战性的问题。