Department of Hematology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, The Netherlands; and.
Département d'Hématologie, Programme de Transplantation et de Thérapie Cellulaire, Centre de Recherche en Cancérologie de Marseille, Institut Paoli Calmettes, Marseille, France.
Blood. 2016 Jan 7;127(1):62-70. doi: 10.1182/blood-2015-07-604546. Epub 2015 Dec 10.
Postremission therapy in patients with acute myeloid leukemia (AML) may consist of continuing chemotherapy or transplantation using either autologous or allogeneic stem cells. Patients with favorable subtypes of AML generally receive chemotherapeutic consolidation, although recent studies have also suggested favorable outcome after hematopoietic stem cell transplantation (HSCT). Although allogeneic HSCT (alloHSCT) is considered the preferred type of postremission therapy in poor- and very-poor-risk AML, the place of alloHSCT in intermediate-risk AML is being debated, and autologous HSCT is considered a valuable alternative that may be preferred in patients without minimal residual disease after induction chemotherapy. Here, we review postremission transplantation strategies using either autologous or allogeneic stem cells. Recent developments in the field of alternative donors, including cord blood and haploidentical donors, are highlighted, and we discuss reduced-intensity alloHSCT in older AML recipients who represent the predominant category of patients with AML who have a high risk of relapse in first remission.
缓解后治疗在急性髓系白血病（AML）患者中可能包括继续化疗或使用自体或异体干细胞进行移植。具有有利 AML 亚型的患者通常接受化学巩固治疗，尽管最近的研究也表明造血干细胞移植（HSCT）后有良好的结果。虽然异体 HSCT（alloHSCT）被认为是不良和极不良风险 AML 缓解后治疗的首选类型，但 alloHSCT 在中危 AML 中的地位存在争议，自体 HSCT 被认为是一种有价值的替代方法，在诱导化疗后无微小残留疾病的患者中可能更受欢迎。在这里，我们回顾了使用自体或异体干细胞进行缓解后移植的策略。强调了替代供体领域的最新进展，包括脐带血和单倍体供体，并讨论了在首次缓解中复发风险高的老年 AML 受者中进行低强度 alloHSCT。
