Weill Medical College of Cornell University, New York, NY 10021, USA.
Hematology Am Soc Hematol Educ Program. 2011;2011:43-50. doi: 10.1182/asheducation-2011.1.43.
Approximately 12 000 adults are diagnosed with acute myeloid leukemia (AML) in the United States annually, the majority of whom die from their disease. The mainstay of initial treatment, cytosine arabinoside (ara-C) combined with an anthracycline, was developed nearly 40 years ago and remains the worldwide standard of care. Advances in genomics technologies have identified AML as a genetically heterogeneous disease, and many patients can now be categorized into clinicopathologic subgroups on the basis of their underlying molecular genetic defects. It is hoped that enhanced specificity of diagnostic classification will result in more effective application of targeted agents and the ability to create individualized treatment strategies. This review describes the current treatment standards for induction, consolidation, and stem cell transplantation; special considerations in the management of older AML patients; novel agents; emerging data on the detection and management of minimal residual disease (MRD); and strategies to improve the design and implementation of AML clinical trials.
每年，大约有 12000 名成年人在美国被诊断为急性髓细胞白血病（AML），其中大多数人死于该病。最初的治疗方法主要是阿糖胞苷（ara-C）联合蒽环类药物，这一方法大约在 40 年前开发，至今仍是全球的治疗标准。基因组学技术的进步将 AML 确定为一种遗传异质性疾病，现在许多患者可以根据其潜在的分子遗传缺陷进行临床病理亚组分类。人们希望通过提高诊断分类的特异性，能够更有效地应用靶向药物，并能够制定个体化的治疗策略。这篇综述描述了诱导、巩固和干细胞移植的当前治疗标准；老年 AML 患者治疗的特殊考虑；新型药物；微小残留病（MRD）检测和管理的新数据；以及改善 AML 临床试验设计和实施的策略。
