Division of Hematology and Stem Cell Transplantation Program, AORN Cardarelli Hospital, Naples, Italy.
Department of Biomedicine and Prevention, University of Tor Vergata, Rome, Italy.
Expert Rev Hematol. 2020 Feb;13(2):99-108. doi: 10.1080/17474086.2020.1715207. Epub 2020 Jan 22.
: The clinical outcome of older patients with acute myeloid leukemia (AML) is still poor, especially for those who are unfit to treatments aimed at altering the natural course of the disease. Hypomethylating agents (HMA) offer an important therapeutic opportunity to a consistent number of patients, but long-term results are largely unsatisfactory.: Recently, a number of new agents have been registered for AML, some of which selectively available for older patient population, with promising results in terms of response rate and survival. Furthermore, the upper age limit for allogeneic stem cell transplantation is constantly increasing, so that this procedure is offered and actually given to an increasing number of older patients with AML. A literature review was conducted of the PubMed database for articles published in English as well as for abstracts from most important and recent hematology meetings on AML in older patients.: Appropriate selection among different options on the basis of clinical fitness and molecular findings at diagnosis as well as at relapse would result in improvement of therapeutic results, sparing unnecessary toxicity and optimizing health systems resources.
老年急性髓系白血病（AML）患者的临床结局仍然较差，尤其是那些不适合改变疾病自然病程的治疗方法的患者。低甲基化剂（HMA）为相当数量的患者提供了重要的治疗机会，但长期结果大多不尽如人意。最近，许多新的药物已被注册用于 AML，其中一些药物专门针对老年患者群体，在反应率和生存率方面取得了有希望的结果。此外，异基因干细胞移植的年龄上限不断提高，因此该手术被提供并实际应用于越来越多的老年 AML 患者。对 PubMed 数据库中的英文文章以及最近关于老年 AML 的血液学会议摘要进行了文献回顾。根据临床适应性和诊断时以及复发时的分子发现，在不同选择之间进行适当选择，将改善治疗结果，避免不必要的毒性，并优化卫生系统资源。
