De Kouchkovsky I, Abdul-Hay M
Department of Medicine, New York University School of Medicine, New York, NY, USA.
Department of Hematology/Oncology, New York University Perlmutter Cancer Center, New York, NY, USA.
Blood Cancer J. 2016 Jul 1;6(7):e441. doi: 10.1038/bcj.2016.50.
Acute myeloid leukemia (AML) is the most common acute leukemia in adults, with an incidence of over 20 000 cases per year in the United States alone. Large chromosomal translocations as well as mutations in the genes involved in hematopoietic proliferation and differentiation result in the accumulation of poorly differentiated myeloid cells. AML is a highly heterogeneous disease; although cases can be stratified into favorable, intermediate and adverse-risk groups based on their cytogenetic profile, prognosis within these categories varies widely. The identification of recurrent genetic mutations, such as FLT3-ITD, NMP1 and CEBPA, has helped refine individual prognosis and guide management. Despite advances in supportive care, the backbone of therapy remains a combination of cytarabine- and anthracycline-based regimens with allogeneic stem cell transplantation for eligible candidates. Elderly patients are often unable to tolerate such regimens, and carry a particularly poor prognosis. Here, we review the major recent advances in the treatment of AML.
急性髓系白血病（AML）是成人中最常见的急性白血病，仅在美国每年就有超过20000例的发病率。大的染色体易位以及造血增殖和分化相关基因的突变导致低分化髓系细胞的积累。AML是一种高度异质性疾病；尽管根据细胞遗传学特征可将病例分为预后良好、中等和不良风险组，但这些类别中的预后差异很大。复发性基因突变如FLT3-ITD、NMP1和CEBPA的鉴定有助于完善个体预后并指导治疗。尽管支持治疗取得了进展，但治疗的主要方法仍然是基于阿糖胞苷和蒽环类药物的联合方案，并对符合条件的患者进行异基因干细胞移植。老年患者往往无法耐受此类方案，预后特别差。在此，我们综述了AML治疗方面最近的主要进展。
