NCT-Trial Center, National Center for Tumor Diseases, German Cancer Research Center, Heidelberg, Germany; Department of Hematology, Oncology, and Rheumatology at Heidelberg University Hospital, University of Heidelberg, Heidelberg, Germany.
Department of Hematology, Oncology, and Rheumatology at Heidelberg University Hospital, University of Heidelberg, Heidelberg, Germany.
Semin Hematol. 2019 Apr;56(2):96-101. doi: 10.1053/j.seminhematol.2018.08.005. Epub 2018 Aug 29.
Intensive induction chemotherapy followed by postremission treatment with either high-dose cytarabine-based regimens, autologous or allogeneic hematopoietic stem cell transplantation is still recognized as the main road toward cure in acute myeloid leukemia (AML). Pretreatment risk classification remains a key determinant of type and intensity of post-remission therapy. Still, high-dose cytarabine-based consolidation therapy is a cornerstone of postremission therapy with some recent adjustments regarding dosage and schedule. Current approvals of midostaurin, gemtuzumab ozogamicin, CPX-351, and ivosidenib as well as enasidenib comprise induction as well as consolidation therapy. In recent years measurable residual disease assessment is increasingly used to dynamically fine tune treatment during postremission treatment.
强化诱导化疗后进行缓解后治疗,包括高剂量阿糖胞苷为基础的方案、自体或异基因造血干细胞移植,仍然被认为是急性髓细胞白血病(AML)治愈的主要途径。预处理风险分类仍然是缓解后治疗类型和强度的关键决定因素。然而,高剂量阿糖胞苷为基础的巩固治疗是缓解后治疗的基石,最近在剂量和方案方面进行了一些调整。目前,米哚妥林、吉妥珠单抗奥佐米星、CPX-351 和ivosidenib 以及enasidenib 的批准包括诱导和巩固治疗。近年来,可测量残留疾病评估越来越多地用于在缓解后治疗期间动态微调治疗。