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急性髓系白血病的新型治疗选择

Novel therapeutic options in Acute Myeloid Leukemia.

作者信息

Medinger Michael, Lengerke Claudia, Passweg Jakob

机构信息

Divisions of Hematology, Department of Medicine, University Hospital Basel, Petersgraben 4, 4031 Basel, Switzerland; Divisions of Internal Medicine, Department of Medicine, University Hospital Basel, Petersgraben 4, 4031 Basel, Switzerland.

Divisions of Hematology, Department of Medicine, University Hospital Basel, Petersgraben 4, 4031 Basel, Switzerland.

出版信息

Leuk Res Rep. 2016 Oct 1;6:39-49. doi: 10.1016/j.lrr.2016.09.001. eCollection 2016.

Abstract

Acute myeloid leukemia (AML) is a biologically complex and molecularly and clinically heterogeneous disease, and its incidence is increasing as the population ages. Cytogenetic anomalies and mutation testing remain important prognostic tools for tailoring treatment after induction therapy. Despite major advances in understanding the genetic landscape of AML and its impact on the pathophysiology and biology of the disease, as well as the rapid development of new drugs, standard treatment options have not experienced major changes during the past three decades. Especially for patients with intermediate or high-risk AML, which often show relapse. Allogeneic hematopoietic stem cell transplantation (HSCT) remains the best chance for cure. Here we review the state of the art therapy of AML, with special focus on new developments in immunotherapies and cellular therapies including HSCT and particularly discuss the impact of new conditioning and haplo-identical donor regimens for HSCT, post-transplant strategies for preventing and treating relapse, and emerging novel therapeutic options.

摘要

急性髓系白血病(AML)是一种生物学复杂且在分子和临床方面具有异质性的疾病,并且随着人口老龄化其发病率正在上升。细胞遗传学异常和突变检测仍然是诱导治疗后制定个体化治疗方案的重要预后工具。尽管在了解AML的基因图谱及其对疾病病理生理学和生物学的影响方面取得了重大进展,以及新药迅速发展,但在过去三十年中标准治疗方案并未发生重大变化。特别是对于经常复发的中高危AML患者。异基因造血干细胞移植(HSCT)仍然是治愈的最佳机会。在此,我们综述AML的最新治疗方法,特别关注免疫疗法和细胞疗法(包括HSCT)的新进展,并特别讨论HSCT新的预处理方案和单倍体相合供体方案、移植后预防和治疗复发的策略以及新兴的新型治疗选择的影响。

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