National Hospital Organization Nagoya Medical Center, Nagoya, Japan.
Nagoya J Med Sci. 2020 May;82(2):151-160. doi: 10.18999/nagjms.82.2.151.
Among elderly patients with acute myeloid leukemia (AML), especially those who are unfit for intensive chemotherapy, a policy of reduced-intensity chemotherapy or conservative observation has been chosen, resulting in unmet medical needs. Clinical trials using anticancer drugs including antimetabolites or drugs targeted to cell cycle-related molecules failed to show superiority over conventional treatments. Recently, drugs targeted to Bcl-2, SMO, FLT3, and IDH1/2 have been shown to prolong overall survival alone or in combination with reduced-intensity chemotherapy. These treatments are likely to reshape the therapeutic landscape of AML, which will be personalized for individual patients based on leukemia genetics.
在老年急性髓系白血病（AML）患者中，特别是那些不适合强化化疗的患者，选择了低强度化疗或保守观察的策略，但这并不能满足医疗需求。使用包括抗代谢物或针对细胞周期相关分子的药物在内的抗癌药物的临床试验并未显示出优于传统治疗的优势。最近，靶向 Bcl-2、SMO、FLT3 和 IDH1/2 的药物已被证明可单独或与低强度化疗联合延长总生存期。这些治疗方法可能会改变 AML 的治疗格局，根据白血病遗传学为每个患者进行个体化治疗。
