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小儿急性髓系白血病的新型疗法:通过纳入目前用于成人的治疗方法构建未来策略

[Novel therapies for pediatric acute myeloid leukemia: building future strategies through incorporation of treatment currently used in adults].

作者信息

Moritake Hiroshi

机构信息

Division of Pediatrics, Department of Developmental and Urological Reproductive Medicine, Faculty of Medicine, University of Miyazaki.

出版信息

Rinsho Ketsueki. 2020;61(6):665-672. doi: 10.11406/rinketsu.61.665.

Abstract

In Japan, acute myeloid leukemia (AML) accounts for approximately 25% of all pediatric leukemias, with approximately 150 cases of newly diagnosed AML occurring annually. Approximately 10% of patients have primary induction failure and 30% of patients, who initially achieve remission in primary treatments, subsequently relapse. Novel treatment modalities need to be developed to further improve the prognosis of pediatric AML patients. AML is a heterogeneous genetic disease characterized by changes in the genome of hematopoietic progenitor cells. Recent studies that have made progress in research related to the pathogenesis of AML have suggested that genotype-specific treatment strategies are associated with increased efficacy. Potential new therapeutic alternatives for pediatric AML include: tyrosine kinase inhibitors, monoclonal or bispecific T-cell engager antibodies, chimeric antigen receptor T-cell therapy, and metabolic agents. This review highlights the current landscape of novel therapeutic approaches for childhood AML, including the results of both preclinical and clinical trials, as well as introducing the results of several preceding adult clinical studies, which could potentially be translated into pediatric AML patients.

摘要

在日本,急性髓系白血病(AML)约占所有儿童白血病的25%,每年约有150例新诊断的AML病例。约10%的患者存在初次诱导失败,而在初次治疗中最初获得缓解的患者中有30%随后复发。需要开发新的治疗方式以进一步改善儿童AML患者的预后。AML是一种异质性遗传疾病,其特征是造血祖细胞基因组发生改变。近期在AML发病机制相关研究中取得进展的研究表明,基因型特异性治疗策略与疗效提高相关。儿童AML潜在的新治疗选择包括:酪氨酸激酶抑制剂、单克隆或双特异性T细胞衔接抗体、嵌合抗原受体T细胞疗法和代谢剂。本综述重点介绍了儿童AML新型治疗方法的当前情况,包括临床前和临床试验的结果,以及介绍了几项先前成人临床研究的结果,这些结果可能转化应用于儿童AML患者。

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