Loke Justin, Vyas Hrushikesh, Craddock Charles
Centre for Clinical Haematology, Queen Elizabeth Hospital, Birmingham, United Kingdom.
Cancer Research UK Clinical Trials Unit, University of Birmingham, Birmingham, United Kingdom.
Front Oncol. 2021 Apr 15;11:666091. doi: 10.3389/fonc.2021.666091. eCollection 2021.
Acute Myeloid Leukemia (AML) is the commonest indication for allogeneic stem cell transplantation (allo-SCT) worldwide. The increasingly important role of allo-SCT in the management of AML has been underpinned by two important advances. Firstly, improvements in disease risk stratification utilizing genetic and Measurable Residual Disease (MRD) technologies permit ever more accurate identification of allo-mandatory patients who are at high risk of relapse if treated by chemotherapy alone. Secondly, increased donor availability coupled with the advent of reduced intensity conditioning (RIC) regimens has substantially expanded transplant access for patients with high risk AML In patients allografted for AML disease relapse continues to represent the commonest cause of transplant failure and the development of novel strategies with the potential to reduce disease recurrence represents a major unmet need.
急性髓系白血病(AML)是全球范围内异基因造血干细胞移植(allo-SCT)最常见的适应症。allo-SCT在AML治疗中日益重要的作用得益于两项重要进展。首先,利用基因和可测量残留病(MRD)技术改进疾病风险分层,能够更准确地识别出那些若仅接受化疗则复发风险高、必须进行allo-SCT的患者。其次,供体来源增加以及低强度预处理(RIC)方案的出现,大幅扩大了高危AML患者的移植机会。在接受allo-SCT治疗的AML患者中,疾病复发仍是移植失败最常见的原因,开发有可能降低疾病复发的新策略仍是一项重大的未满足需求。