Chen Miao, Wang Shu-Jie
Department of Internal Medicine, PUMC Hospital, CAMS and PUMC, Bejing 100730, China.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2009 Oct;31(5):634-8.
Elderly patients with acute myeloid leukemia (AML) tolerate intensive chemotherapy poorly and usually have poor prognosis. For elderly patients in good physical condition and without severe dysfunction of major organs, standard intensive induction chemotherapy is superior to non-intensive treatment or best supportive care alone. However, low-dose chemotherapy as post-remission treatment has more advantages than intensive chemotherapy. Intensive chemotherapy is not suitable for patients with unfavorable karyotypes, and genetic analysis is needed for individualized therapy regimen. Gemtuzumab ozogamicin may improve the survival of elderly patients who are intolerant to standard chemotherapy. Some patients may benefit from the transplantation of allogeneic stem cells after reduced-intensity conditioning.
老年急性髓系白血病(AML)患者对强化化疗耐受性差,且通常预后不良。对于身体状况良好且无主要器官严重功能障碍的老年患者,标准强化诱导化疗优于非强化治疗或单纯最佳支持治疗。然而,低剂量化疗作为缓解后治疗比强化化疗具有更多优势。强化化疗不适用于核型不良的患者,需要进行基因分析以制定个体化治疗方案。吉妥珠单抗奥唑米星可能会提高不耐受标准化疗的老年患者的生存率。一些患者可能会从减低强度预处理后的异基因干细胞移植中获益。