Thomas Xavier, Le Jeune Caroline
Department of Hematology, Hospices Civils de Lyon, Lyon-Sud Hospital, Bat.1G, 165 chemin du Grand Revoyet, 69495, Pierre Bénite, France.
Curr Treat Options Oncol. 2017 Jan;18(1):2. doi: 10.1007/s11864-017-0445-5.
There is no standard of care for older patients with acute myeloid leukemia (AML) unfit for intensive chemotherapy. AML in older patients remains an area of significant unmet need necessitating novel therapeutic strategies. In older patients with normal cytogenetics, molecular variables can be helpful in refining risk. This molecular revolution has promoted a shift in the treatment paradigm of AML. Open new questions concern the necessity of an individualized therapy that may take into account not only an increase in survival but also the maintenance or improvement in terms of quality of life, the management of symptoms, and a maximization of time outside of hospital care. Molecular abnormalities provide the genomic footprint for the development of targeted therapies. Clinical trials testing the activity of these new agents are ongoing and may reshape treatment strategies for these patients. One promising strategy is to combine low-intensity treatments with novel agents.
对于不适合强化化疗的老年急性髓系白血病（AML）患者，尚无标准治疗方案。老年患者的AML仍然是一个存在重大未满足需求的领域，需要新的治疗策略。对于细胞遗传学正常的老年患者，分子变量有助于细化风险评估。这种分子层面的变革推动了AML治疗模式的转变。新出现的问题涉及个体化治疗的必要性，这种治疗不仅要考虑生存期的延长，还要兼顾生活质量的维持或改善、症状管理以及尽量延长非住院治疗时间。分子异常为靶向治疗的发展提供了基因组特征。测试这些新药物活性的临床试验正在进行，可能会重塑这些患者的治疗策略。一种有前景的策略是将低强度治疗与新型药物联合使用。
