急性早幼粒细胞白血病（APL）：实现全面治愈面临的尚存挑战。
Acute promyelocytic leukemia (APL): remaining challenges towards a cure for all.
作者信息
Stahl Maximilian, Tallman Martin S
机构信息
Leukemia Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
出版信息
Leuk Lymphoma. 2019 Dec;60(13):3107-3115. doi: 10.1080/10428194.2019.1613540. Epub 2019 Dec 16.
Abstract
The application of all-trans retinoic acid (ATRA) and arsenic trioxide (ATO) has revolutionized the treatment of acute promyelocytic leukemia (APL). More than 80-90% of patients are expected to be cured with a combination of ATRA, ATO and/or chemotherapy. In this review, we focus on the remaining obstacles to a cure for all patients with APL. We review the issue of early death and coagulopathy and discuss the particular challenges in the care of patients with high-risk APL and patients with relapsed APL. We also give recommendations and highlight ongoing efforts to improve the persistently high early death rate and the outcomes of high risk and relapsed APL patients.
摘要
全反式维甲酸（ATRA）和三氧化二砷（ATO）的应用彻底改变了急性早幼粒细胞白血病（APL）的治疗方式。预计超过80%-90%的患者通过ATRA、ATO和/或化疗联合治疗可实现治愈。在本综述中，我们聚焦于所有APL患者实现治愈所面临的剩余障碍。我们回顾早期死亡和凝血障碍问题，并讨论高危APL患者和复发APL患者护理中的特殊挑战。我们还给出建议，并强调为改善持续居高不下的早期死亡率以及高危和复发APL患者的治疗结果而正在做出的努力。
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