Ishizawa Jo, Saya Hideyuki
Division of Gene Regulation, Institute for Advanced Medical Research, Keio University School of Medicine.
Nihon Rinsho. 2009 Oct;67(10):1932-7.
Great progress on insight into genetic aberrations of myeloid leukemia via gene expression profiling has led to better understanding of the pathobiology of this heterogeneous disorder. It enabled the development of specific treatment modalities targeted to underlying oncogenic abnormalities, with well established examples of all-trans retinoic acid for the treatment of acute promyelocytic leukemia and imatinib for chronic myeloid leukemia. However, these strategies have not been completely developed yet in that most of brand new targeted therapies have been somewhat far from achieving cure of leukemia and that many problems with regards to drug resistance and recurrence from minimal residual disease remain to be solved. On the other hand, concept of cancer(leukemic) stem cell and its niche has been shedding new light on oncological field these days. This review summarizes the current clinical trials using new targeted therapies and research trends on myeloid leukemia.
通过基因表达谱分析对髓系白血病基因畸变的深入了解取得了巨大进展,这使人们对这种异质性疾病的病理生物学有了更好的认识。它推动了针对潜在致癌异常的特异性治疗方式的发展,全反式维甲酸治疗急性早幼粒细胞白血病以及伊马替尼治疗慢性髓性白血病就是很好的例子。然而,这些策略尚未完全成熟,因为大多数全新的靶向治疗在治愈白血病方面仍有一定差距,并且关于耐药性和微小残留病复发的许多问题仍有待解决。另一方面,癌症(白血病)干细胞及其微环境的概念近年来为肿瘤学领域带来了新的启示。本综述总结了目前使用新靶向治疗的临床试验以及髓系白血病的研究趋势。