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急性髓系白血病的分子标志物。

Molecular markers in acute myeloid leukaemia.

机构信息

Department of Medical and Molecular Genetics, King's College London School of Medicine, London, UK.

出版信息

Int J Hematol. 2012 Aug;96(2):153-63. doi: 10.1007/s12185-012-1123-9. Epub 2012 Jul 13.

Abstract

An increasing number of cytogenetic and molecular genetic aberrations have been identified in acute myeloid leukaemia (AML), highlighting the biological heterogeneity of the disease. Moreover, the characterisation of specific molecular abnormalities provides the basis for targeted therapies, such as all trans retinoic acid (ATRA) and arsenic trioxide treatment in acute promyelocytic leukaemia or tyrosine kinase inhibitors in AML with FLT3 mutations. Several cytogenetic and molecular genetic changes have been shown to be prognostically relevant and have been acknowledged in the latest WHO classification of AML as separate entities. A detailed marker assessment at diagnosis is crucial for risk-stratification of AML patients, allowing the identification of those at high risk of relapse, who may benefit from early allogeneic stem cell transplantation. Finally, molecular markers are important for the detection of minimal residual disease after initial therapy and during long-term follow-up, which enables a more tailored treatment approach for individual AML patients.

摘要

越来越多的细胞遗传学和分子遗传学异常在急性髓细胞白血病(AML)中被发现,突出了该疾病的生物学异质性。此外,特定分子异常的特征为靶向治疗提供了基础,例如全反式维甲酸(ATRA)和三氧化二砷治疗急性早幼粒细胞白血病,或 FLT3 突变的 AML 的酪氨酸激酶抑制剂。已经证明,一些细胞遗传学和分子遗传学改变与预后相关,并在 AML 的最新世界卫生组织分类中被确认为独立实体。在诊断时进行详细的标志物评估对于 AML 患者的风险分层至关重要,有助于确定那些复发风险高的患者,他们可能受益于早期异基因干细胞移植。最后,分子标志物对于初始治疗后和长期随访期间微小残留疾病的检测很重要,这使得针对个体 AML 患者的治疗方法更加个体化。

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