Roswell Park Comprehensive Cancer Center, Elm and Carlton Streets, Buffalo, NY, USA.
Taussig Cancer Institute, Cleveland Clinic, 10900 Euclid Ave, Cleveland, OH, USA.
Leuk Res. 2020 Apr;91:106339. doi: 10.1016/j.leukres.2020.106339. Epub 2020 Feb 26.
Acute myeloid leukemia (AML) is primarily a disease of older adults. Many older patients with AML are not candidates for intensive chemotherapy regimens aimed at inducing remission before transplantation. The prognosis for this patient population remains poor, with 5-year overall survival (OS) rates of less than 10 %. At present, there is no standard of care, and clinical trials should be considered. Hypomethylating agents often are the mainstay of treatment in this setting; however, improved genetic profiling and risk stratification based on molecular, biological, and clinical characteristics of AML enhance the ability to identify an individual patient's risk and can refine therapeutic options. Over the past 2 years, several novel agents have been approved for AML patients in either the frontline or relapsed settings. Additional agents have also shown promising activity. It is becoming a challenge for physicians to navigate these different options and select the optimal therapy or combination of therapies. The aim of this review is to summarize the available information to assist with treatment decisions for leukemia patients who are not suitable for intensive chemotherapy.
急性髓系白血病（AML）主要发生于老年人。许多不适合接受强化化疗方案的老年 AML 患者，这些方案旨在在移植前诱导缓解。该患者人群的预后仍然较差，5 年总生存率（OS）不到 10%。目前尚无标准治疗方法，应考虑临床试验。在这种情况下，低甲基化剂通常是治疗的基础；然而，基于 AML 的分子、生物学和临床特征进行的遗传分析和风险分层的改进，提高了识别个体患者风险的能力，并可以优化治疗选择。在过去的 2 年中，已经有几种新的药物被批准用于 AML 患者的一线或复发治疗。其他药物也显示出有前景的活性。对于医生来说，驾驭这些不同的选择并选择最佳的治疗方法或联合治疗方法已成为一项挑战。本文综述了现有的资料，以协助为不适合强化化疗的白血病患者制定治疗决策。
