Division of Hematology, Department of Internal Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
Institute of Haematology, Università Cattolica Sacro Cuore, Rome, Italy.
Bone Marrow Transplant. 2017 Nov;52(11):1504-1511. doi: 10.1038/bmt.2017.83. Epub 2017 May 15.
AML is currently the first indication for allogeneic hematopoietic stem cell transplantation (allo-HSCT), as shown by international transplant registries. The conditioning regimens are classified as myeloablative conditioning, non-myeloablative or reduced intensity conditioning. Targeted radioimmunotherapy such as anti-CD45 antibody have also been added to the conditioning regimen in an attempt to improve tumor cell kill. Refinement of standard regimens has led to a reduction of non-relapse mortality, also in the older age group over 60 or 70 years of age. Relapse post allo-HSCT remains an important issue, especially for patients who undergo transplant with residual or refractory disease. In these patients, pre- and post-transplant interventions need to be considered.
AML 目前是异体造血干细胞移植(allo-HSCT)的首要适应证,这一点已被国际移植登记处证实。预处理方案分为清髓性、非清髓性或减低强度。靶向放射免疫疗法,如抗 CD45 抗体,也被添加到预处理方案中,试图提高肿瘤细胞杀伤作用。标准方案的完善导致非复发死亡率降低,在年龄大于 60 或 70 岁的老年患者中尤其如此。allo-HSCT 后复发仍然是一个重要问题,尤其是对于那些移植时存在残留或难治性疾病的患者。在这些患者中,需要考虑移植前和移植后的干预措施。