The Pharmaceutical Research Institute, Albany College of Pharmacy and Health Sciences, 1 Discovery Drive, Rensselaer, NY, 12144, USA.
Hematology Unit, Clinical Pathology Department, Mansoura Faculty of Medicine, Mansoura University, Mansoura, Egypt.
Curr Treat Options Oncol. 2021 Jul 2;22(9):76. doi: 10.1007/s11864-021-00880-x.
Cytogenetics and mutation identification in acute myeloid leukemia have allowed for more targeted therapy. Many therapies have been approved by the FDA in the last 3 years including gilteritinib and azacitidine but the overall survival has remained stagnant at 25%. The inability to achieve complete remission was related to the residual leukemic stem cells (LSCs). Thus, the relationship between bone marrow niche and LSCs must be further explored to prevent treatment relapse/resistance. The development of immunotherapy and nanotechnology may play a role in future therapy to achieve the complete remission. Nano-encapsulation of drugs can improve drugs' bioavailability, help drugs evade resistance, and provide combination therapy directly to the cancer cells. Studies indicate targeting surface antigens such as CLL1 and CD123 using chimeric antibody receptor T cells can improve survival outcomes. Finally, new discoveries indicate that inhibiting integrin αvβ3 and acid ceramidase may prove to be efficacious.
在急性髓系白血病中进行细胞遗传学和突变鉴定，使得能够进行更有针对性的治疗。在过去的 3 年中，许多疗法已获得 FDA 批准，包括 gilteritinib 和阿扎胞苷，但总体生存率仍停滞在 25%。无法实现完全缓解与残留的白血病干细胞（LSCs）有关。因此，必须进一步探索骨髓龛与 LSCs 之间的关系，以防止治疗复发/耐药。免疫疗法和纳米技术的发展可能在未来的治疗中发挥作用，以实现完全缓解。药物的纳米封装可以提高药物的生物利用度，帮助药物逃避耐药性，并直接将联合疗法提供给癌细胞。研究表明，使用嵌合抗体受体 T 细胞靶向表面抗原（如 CLL1 和 CD123）可以改善生存结果。最后，新的发现表明，抑制整合素 αvβ3 和酸性神经酰胺酶可能是有效的。
