Blood and Marrow Transplantation Program, University of Minnesota, Minneapolis, Minnesota, USA.
Curr Opin Hematol. 2011 Nov;18(6):388-94. doi: 10.1097/MOH.0b013e32834b6158.
Relapse remains a major cause of treatment failure for acute myeloid leukemia (AML) patients treated with allogeneic hematopoietic stem cell transplantation (allo-HCT). Most patients that recur will perish due to low treatment efficacy, toxicity, or frailty issues. This review summarizes recent developments in clinical research and therapeutic applications for prevention and treatment of this complication of transplantation.
Several groups have demonstrated that monitoring minimal residual disease (MRD) after allo-HCT is feasible and is predictive of impending hematologic recurrence. The introduction of novel antileukemia agents in the preparative regimen, maintenance of remission treatment posttransplant, and early MRD-based therapeutic interventions all have the potential to improve outcomes.
Innovative basic and clinical investigation is urgently needed to improve treatment and prevention of AML recurrence after allogeneic transplantation.
对于接受异基因造血干细胞移植（allo-HCT）治疗的急性髓系白血病（AML）患者，复发仍然是治疗失败的主要原因。大多数复发的患者由于治疗效果不佳、毒性或虚弱问题而死亡。本综述总结了预防和治疗移植后这一并发症的临床研究和治疗应用的最新进展。
有几个小组已经证明，在 allo-HCT 后监测微小残留病（MRD）是可行的，并且可以预测即将发生的血液学复发。在预处理方案中引入新型抗白血病药物、移植后缓解维持治疗以及早期基于 MRD 的治疗干预都有可能改善结果。
迫切需要创新的基础和临床研究来改善异基因移植后 AML 复发的治疗和预防。
