Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd Unit 463, Houston, TX, 77030, USA.
Department of Leukemia, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 428, Houston, TX, 77030, USA.
Curr Treat Options Oncol. 2021 Mar 20;22(5):39. doi: 10.1007/s11864-021-00841-4.
The treatment of acute myeloid leukemia (AML) has evolved considerably over the past several years. Advances in the field have historically benefited younger patients; however, a growing understanding of the molecular basis of leukemogenesis has brought multiple targeted agents to the clinic for patients of all ages. These therapies have expanded the therapeutic landscape for elderly patients from more than best supportive care and low-intensity monotherapy. In general, we currently utilize a backbone regimen of a hypomethylating agent (HMA) or low-intensity chemotherapy with the BCL-2 inhibitor venetoclax for the majority of elderly patients with newly diagnosed AML. For patients with targetable mutations, we employ a doublet/triplet strategy of HMA + a targeted inhibitor +/- venetoclax, often in the context of a clinical trial. CPX-351 is reserved for patients with secondary or therapy-related AML. In this review, we will outline our approach to the treatment of elderly patients with AML, with particular emphasis on recently approved agents and emerging novel therapies.
在过去的几年中，急性髓系白血病（AML）的治疗已经有了很大的发展。该领域的进展历史上使年轻患者受益；然而，对白血病发生的分子基础的认识不断加深，为所有年龄段的患者带来了多种靶向药物。这些疗法为老年患者提供了除最佳支持治疗和低强度单一疗法以外的治疗选择。一般来说，我们目前为大多数新诊断为 AML 的老年患者使用低甲基化药物（HMA）或低强度化疗联合 BCL-2 抑制剂维奈托克作为基础方案。对于有靶向突变的患者，我们采用 HMA+靶向抑制剂 +/-维奈托克的双联/三联策略，通常在临床试验的背景下进行。CPX-351 保留用于治疗继发性或治疗相关性 AML 的患者。在这篇综述中，我们将概述我们治疗老年 AML 患者的方法，特别强调最近批准的药物和新兴的新型疗法。
