Division of Hematology and Blood & Marrow Transplant, Markey Cancer Center, College of Medicine, University of Kentucky, 800 Rose St, Lexington, KY, 40536, USA.
Department of Internal Medicine, School of Medicine, University of Missouri-Kansas City, 2411 Holmes St, Kansas City, MO, 64108, USA.
Ann Hematol. 2019 Mar;98(3):561-579. doi: 10.1007/s00277-018-3562-8. Epub 2018 Nov 23.
The combination of cytarabine and an anthracycline has been the standard of care for the induction of remission in acute myeloid leukemia (AML). The response to treatment and survival of adult patients with AML are still variable and depend on multiple factors. Therefore, there have been many efforts to improve the response to treatment and survival rates by either increasing the cytarabine dose or adding a third agent to the standard induction chemotherapy regimen. Unfortunately, attempts to improve response and survival have been mostly unsuccessful. Recent clinical trials and retrospective studies explored the addition of cladribine to standard induction chemotherapy for AML. Some of these studies showed higher rates of complete remission, and one showed improved survival. In this review, we will discuss the antileukemic properties of cladribine and summarize the recent clinical data regarding its incorporation into the induction therapy for adult AML.
阿糖胞苷和蒽环类药物的联合应用一直是急性髓细胞白血病（AML）诱导缓解的标准治疗方法。成人 AML 患者的治疗反应和生存仍然存在差异，这取决于多种因素。因此，人们一直在努力通过增加阿糖胞苷的剂量或在标准诱导化疗方案中添加第三种药物来提高治疗反应和生存率。不幸的是，提高反应率和生存率的尝试大多没有成功。最近的临床试验和回顾性研究探讨了在 AML 的标准诱导化疗中加入克拉屈滨。其中一些研究显示完全缓解率更高，一项研究显示生存改善。在这篇综述中，我们将讨论克拉屈滨的抗白血病特性，并总结最近关于将其纳入成人 AML 诱导治疗的临床数据。
