Department of Biomedicine and Prevention, University Tor Vergata, Rome, Italy ; Laboratory of Neuro-Oncohematology, Santa Lucia Foundation, Rome, Italy.
Mediterr J Hematol Infect Dis. 2013 Jun 8;5(1):e2013045. doi: 10.4084/MJHID.2013.045. Print 2013.
Unlike other forms of AML, APL is less frequently diagnosed in the elderly and has a relatively favourable outcome. Elderly patients with APL seem at least as responsive to therapy as do younger patients, but rates of response and survival are lower in this age setting owing to a higher incidence of early deaths and deaths in remission when conventional treatment with ATRA and chemotherapy is used. Elderly APL patients are more likely to present with low-risk features compared with younger patients, and this may explain the relative low risk of relapse reported in several clinical studies. Alternative approaches, such as arsenic trioxide and gentuzumab ozogamicin have been tested with success in this setting and could replace in the near future frontline conventional chemotherapy and ATRA.
与其他形式的 AML 不同，APL 在老年人中较少被诊断出，且预后相对较好。老年 APL 患者对治疗的反应似乎与年轻患者一样，但由于常规使用 ATRA 和化疗治疗时早期死亡率和缓解期死亡率较高，因此该年龄组的反应率和生存率较低。与年轻患者相比，老年 APL 患者更有可能表现出低危特征，这可能解释了几项临床研究报告的相对较低的复发风险。在这种情况下，已经成功测试了替代方法，如三氧化二砷和吉妥珠单抗奥佐米星，并且可能在不久的将来替代一线常规化疗和 ATRA。
