Division of Hematology, Tokyo Metropolitan Ohtsuka Hospital, 2-8-1 Minamiohtsuka, Toshima-ku, Tokyo, 170-8476, Japan.
Int J Hematol. 2012 Aug;96(2):171-7. doi: 10.1007/s12185-012-1150-6. Epub 2012 Aug 2.
Acute myeloid leukemia (AML) is the most common adult leukemia in Japan. The treatment for AML consists of induction, consolidation, and maintenance therapies. To improve outcomes in the treatment of AML, the Japan Adult Leukemia Study Group has conducted six studies in AML patients aged 15-64 years since 1987. In AML201 study, IDR (12 mg/m(2)/day for 3 days) or DNR (50 mg/m(2)/day for 5 days) in combination with Ara-C (100 mg/m(2)/day continuous infusion for 7 days) was established as the standard induction therapy, and four courses of combination chemotherapy using non-cross-resistant agents for non-core binding factor (CBF) AML or three courses of high-dose Ara-C for CBF AML was established as the standard consolidation therapy. The AML97 study showed that allo-HSCT from an HLA-identical sibling donor reduced relapse incidence and improved disease-free survival (DFS), but did not significantly impact overall survival (OS) in poor or intermediate risk patients. Despite these studies by JALSG, only about one-third of AML patients remain free of disease for more than 7 years. The JALSG is now conducting the AML209 study to adapt individual therapies according to genetic alterations.
急性髓细胞白血病（AML）是日本最常见的成人白血病。AML 的治疗包括诱导、巩固和维持治疗。为了改善 AML 治疗的结果，日本成人白血病研究组自 1987 年以来已经在 15-64 岁的 AML 患者中开展了六项研究。在 AML201 研究中，IDR（12mg/m(2)/天，连用 3 天）或 DNR（50mg/m(2)/天，连用 5 天）联合Ara-C（100mg/m(2)/天连续输注 7 天）被确立为标准诱导治疗，并且对于非核心结合因子（CBF）AML 采用非交叉耐药药物的四个疗程联合化疗或对于 CBF AML 采用高剂量 Ara-C 的三个疗程被确立为标准巩固治疗。AML97 研究表明，来自 HLA 完全匹配的同胞供体的同种异体 HSCT 降低了复发率并改善了无病生存（DFS），但在预后不良或中等风险患者中对总生存（OS）没有显著影响。尽管 JALSG 开展了这些研究，但只有大约三分之一的 AML 患者疾病无复发超过 7 年。JALSG 目前正在开展 AML209 研究，根据遗传改变来调整个体化治疗。
