Lonetti Annalisa, Pession Andrea, Masetti Riccardo
"Giorgio Prodi" Interdepartmental Cancer Research Centre, University of Bologna, Bologna, Italy.
Pediatric Hematology-Oncology Unit, Department of Medical and Surgical Sciences DIMEC, University of Bologna, Bologna, Italy.
Front Pediatr. 2019 Nov 15;7:463. doi: 10.3389/fped.2019.00463. eCollection 2019.
Acute myeloid leukemia (AML) is a hematopoietic disorder characterized by numerous cytogenetic and molecular aberrations that accounts for ~25% of childhood leukemia diagnoses. The outcome of children with AML has increased remarkably over the past 30 years, with current survival rates up to 70%, mainly due to intensification of standard chemotherapy and improvements in risk classification, supportive care, and minimal residual disease monitoring. However, childhood AML prognosis remains unfavorable and relapse rates are still around 30%. Therefore, novel therapeutic approaches are needed to increase the cure rate. In AML, the presence of gene mutations and rearrangements prompted the identification of effective targeted molecular strategies, including kinase inhibitors, cell pathway inhibitors, and epigenetic modulators. This review will discuss several new drugs that recently received US Food and Drug Administration approval for AML treatment and promising strategies to treat childhood AML, including FLT3 inhibitors, epigenetic modulators, and Hedgehog pathway inhibitors.
急性髓系白血病(AML)是一种造血系统疾病,其特征是存在众多细胞遗传学和分子异常,约占儿童白血病诊断病例的25%。在过去30年里,AML患儿的治疗结果有了显著改善,目前的生存率高达70%,这主要归功于标准化疗的强化以及风险分类、支持治疗和微小残留病监测方面的改进。然而,儿童AML的预后仍然不容乐观,复发率仍在30%左右。因此,需要新的治疗方法来提高治愈率。在AML中,基因突变和重排的存在促使人们确定了有效的靶向分子策略,包括激酶抑制剂、细胞通路抑制剂和表观遗传调节剂。本综述将讨论几种最近获得美国食品药品监督管理局批准用于治疗AML的新药以及治疗儿童AML的有前景的策略,包括FLT3抑制剂、表观遗传调节剂和Hedgehog通路抑制剂。