Lin Tara L, Pagano Livio
Medicine, Division of Hematologic Malignancies and Cellular Therapeutics, University of Kansas Medical Center, Kansas City, KS, USA.
Hematology, Fondazione Policlinico Universitario Agostino Gemelli - IRCCS, Rome, Italy.
Expert Rev Hematol. 2021 Mar;14(3):303-314. doi: 10.1080/17474086.2021.1886920. Epub 2021 Mar 24.
: Intensive induction chemotherapy followed by post-remission consolidation and/or allogeneic hematopoietic transplantation has been a standard-of-care therapy for acute myeloid leukemia (AML) for decades. In recent years, a plethora of new agents have been approved for AML treatment, dramatically changing the AML treatment landscape.: This review provides an overview of the current role of intensive chemotherapy in the changing AML treatment landscape. PubMed-indexed publications (through 2020) and abstracts presented at major national and international conferences were reviewed for inclusion.: While intensive chemotherapy is standard-of-care therapy for younger patients with AML, older patients were historically viewed as universally ineligible for intensive chemotherapy; however, several studies suggest many older patients benefit from intensive chemotherapy with a curative intent, and a more holistic approach to determining eligibility for intensive treatment is recommended. Intensive strategies have also been expanded to include novel chemotherapy designs and chemotherapy in combination with targeted agents for patients with certain disease characteristics, which may permit more personalized treatment decisions. Intensive chemotherapy continues to play a pivotal role for the management of many AML patients and can offer the best chance of long-term remission, especially when followed by transplantation.
几十年来，强化诱导化疗后进行缓解后巩固治疗和/或异基因造血移植一直是急性髓系白血病（AML）的标准治疗方法。近年来，大量新型药物已被批准用于AML治疗，极大地改变了AML的治疗格局。
本综述概述了强化化疗在不断变化的AML治疗格局中的当前作用。对PubMed索引的出版物（截至2020年）以及在主要国内和国际会议上发表的摘要进行了审查以纳入研究。
虽然强化化疗是年轻AML患者的标准治疗方法，但老年患者在历史上一直被视为普遍不适合进行强化化疗；然而，多项研究表明，许多老年患者可从具有治愈意图的强化化疗中获益，因此建议采用更全面的方法来确定强化治疗的 eligibility。强化策略也已扩展，包括针对某些疾病特征的患者采用新型化疗设计以及化疗与靶向药物联合使用，这可能允许做出更个性化的治疗决策。强化化疗在许多AML患者的管理中继续发挥关键作用，并且可以提供长期缓解的最佳机会，尤其是在随后进行移植时。
