Division of Hematology-Oncology, Department of Internal Medicine, and Abramson Cancer Center, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Ther Adv Hematol. 2011 Apr;2(2):73-82. doi: 10.1177/2040620711402533.
There are a significant number of patients diagnosed with acute leukemia who either fail to achieve remission or who relapse thereafter. Challenges in treating this patient population include accurately assessing prognosis of disease and whether remission can be achieved; assessing the ability of patients to tolerate aggressive salvage therapies; choosing a salvage therapy that is most likely to succeed; and identifying suitable patients for hematopoietic stem cell transplantation. Despite the development of a variety of new investigational therapies, relapsed or refractory acute myeloid Leukemia remains a difficult clinical problem. Clinicians will need to consider all currently available approaches, including cytotoxic chemotherapy, targeted agents, and allogeneic stem cell transplantation, to optimize outcomes.
有相当数量的急性白血病患者要么未能达到缓解,要么随后复发。治疗这类患者群体的挑战包括准确评估疾病的预后和能否达到缓解;评估患者耐受强化挽救治疗的能力;选择最有可能成功的挽救治疗方法;以及确定适合造血干细胞移植的合适患者。尽管开发了多种新的试验性治疗方法,但复发或难治性急性髓细胞白血病仍然是一个棘手的临床问题。临床医生需要考虑目前所有可用的方法,包括细胞毒性化疗、靶向药物和同种异体干细胞移植,以优化治疗效果。