Amgen Inc., One Amgen Center Drive, Thousand Oaks, CA 91320, USA.
Gehr Family Leukemia Center, City of Hope, Duarte, CA, USA.
Crit Rev Oncol Hematol. 2022 Jul;175:103710. doi: 10.1016/j.critrevonc.2022.103710. Epub 2022 May 16.
Relapse is common in acute myeloid leukemia (AML) and thought to be due to resistance of underlying leukemic stem cells (LSCs) to current standard therapies, although a lack of tools to measure the quantity and quality of these cells in patients precludes the clinical testing of this concept. This review discusses the current knowledge of LSC properties and appraises strategies aimed to bring the therapeutic targeting of LSCs to the bedside to improve patient outcomes. We highlight pathways and targets of interest and summarize available information on drugs that might eradicate LSCs. Future research is needed to close identified gaps in knowledge and provide evidence for the clinical efficacy of LSC-directed therapies to support the development of treatments that eliminate residual disease and prevent relapse, thereby increasing the cure rates of patients with AML.
复发在急性髓系白血病(AML)中很常见,被认为是由于潜在的白血病干细胞(LSCs)对当前标准疗法的耐药性所致,尽管缺乏在患者中测量这些细胞数量和质量的工具,使得无法对这一概念进行临床测试。这篇综述讨论了目前对 LSC 特性的认识,并评估了旨在将 LSC 的治疗靶向推向床边以改善患者预后的策略。我们强调了有兴趣的途径和靶点,并总结了可能根除 LSCs 的药物的现有信息。需要进一步的研究来填补知识空白,并提供 LSC 定向治疗的临床疗效证据,以支持开发消除残留疾病和预防复发的治疗方法,从而提高 AML 患者的治愈率。