Abramson Cancer Center, University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA, 19104, USA.
Best Pract Res Clin Haematol. 2021 Dec;34(4):101334. doi: 10.1016/j.beha.2021.101334. Epub 2021 Nov 3.
Current standard of care for consolidation therapy for AML varies based on age and induction regimen, among other factors. Many trials have sought to determine the optimal dose, number of cycles, and schedule for consolidation with cytarabine. For AML patients under age 60, mid-dose cytarabine is as effective as high-dose cytarabine, results after 3 or 4 cycles of cytarabine in consolidation are comparable but are both superior to only one cycle, and giving cytarabine every 12 h on days 1, 2, and 3 appears to have the same benefit but less toxicity than cytarabine given on days 1, 3, and 5. For those over age 60, the best dose of cytarabine is unknown, but post-remission therapy appears to improve survival for some patients who achieve remission after standard induction, depending on induction regimen used and MRD status at time of remission.
目前，AML 强化治疗的标准护理因年龄和诱导方案等因素而异。许多试验都试图确定阿糖胞苷强化治疗的最佳剂量、周期数和方案。对于年龄小于 60 岁的 AML 患者，中剂量阿糖胞苷与高剂量阿糖胞苷同样有效，在强化治疗中使用 3 或 4 个周期的阿糖胞苷的结果相当，但均优于仅使用一个周期，并且在第 1、2 和 3 天每 12 小时给予阿糖胞苷似乎具有相同的益处，但毒性低于在第 1、3 和 5 天给予阿糖胞苷。对于年龄大于 60 岁的患者，阿糖胞苷的最佳剂量尚不清楚，但缓解后治疗似乎可以改善某些在标准诱导后获得缓解的患者的生存，具体取决于诱导方案和缓解时的微小残留病灶状态。
