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聚焦中危急性髓系白血病:亚分类更新与治疗挑战

A Focus on Intermediate-Risk Acute Myeloid Leukemia: Sub-Classification Updates and Therapeutic Challenges.

作者信息

Awada Hassan, Mustafa Ali Moaath K, Thapa Bicky, Awada Hussein, Seymour Leroy, Liu Louisa, Gurnari Carmelo, Kishtagari Ashwin, Wang Eunice, Baer Maria R

机构信息

Roswell Park Comprehensive Cancer Center, Buffalo, NY 14203, USA.

University of Maryland Greenebaum Comprehensive Cancer Center, Baltimore, MD 21201, USA.

出版信息

Cancers (Basel). 2022 Aug 28;14(17):4166. doi: 10.3390/cancers14174166.

Abstract

Acute myeloid leukemia (AML) represents a heterogeneous group of hematopoietic neoplasms deriving from the abnormal proliferation of myeloid progenitors in the bone marrow. Patients with AML may have highly variable outcomes, which are generally dictated by individual clinical and genomic characteristics. As such, the European LeukemiaNet 2017 and 2022 guidelines categorize newly diagnosed AML into favorable-, intermediate-, and adverse-risk groups, based on their molecular and cytogenetic profiles. Nevertheless, the intermediate-risk category remains poorly defined, as many patients fall into this group as a result of their exclusion from the other two. Moreover, further genomic data with potential prognostic and therapeutic influences continue to emerge, though they are yet to be integrated into the diagnostic and prognostic models of AML. This review highlights the latest therapeutic advances and challenges that warrant refining the prognostic classification of intermediate-risk AML.

摘要

急性髓系白血病(AML)是一组异质性造血系统肿瘤,源于骨髓中髓系祖细胞的异常增殖。AML患者的预后可能差异很大,这通常由个体的临床和基因组特征决定。因此,欧洲白血病网2017年和2022年指南根据新诊断AML患者的分子和细胞遗传学特征,将其分为低危、中危和高危组。然而,中危组的定义仍然不明确,因为许多患者由于被排除在其他两组之外而被归为这一组。此外,尽管尚未整合到AML的诊断和预后模型中,但具有潜在预后和治疗影响的更多基因组数据仍在不断出现。本综述重点介绍了最新的治疗进展和挑战,这些进展和挑战需要完善中危AML的预后分类。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f445/9454629/dcba3fcb856c/cancers-14-04166-g001.jpg

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