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造血干细胞移植前后新药物治疗急性髓细胞白血病患者。

New drugs before, during, and after hematopoietic stem cell transplantation for patients with acute myeloid leukemia.

机构信息

Division of Hematology-Oncology and Blood and Marrow Transplantation Program, Mayo Clinic, Jacksonville, FL.

Department of Internal Medicine, Jacobi Medical Center/Albert Einstein College of Medicine, Bronx, NY.

出版信息

Haematologica. 2023 Feb 1;108(2):321-341. doi: 10.3324/haematol.2022.280798.

Abstract

The treatment of acute myeloid leukemia (AML) has evolved over the past few years with the advent of next-generation sequencing. Targeted therapies alone or in combination with low-dose or high-intensity chemotherapy have improved the outcome of patients with AML treated in the frontline and relapsed/refractory settings. Despite these advances, allogeneic stem cell transplantation (allo-HCT) remains essential as consolidation therapy following frontline treatment in intermediate-and adverse-risk and relapsed/refractory disease. However, many patients relapse, with limited treatment options, hence the need for post-transplant strategies to mitigate relapse risk. Maintenance therapy following allo-HCT was developed for this specific purpose and can exploit either a direct anti-leukemia effect and/or enhance the bona fide graft-versus-leukemia effect without increasing the risk of graft-versus-host disease. In this paper, we summarize novel therapies for AML before, during, and after allo-HCT and review ongoing studies.

摘要

在过去的几年中,随着下一代测序技术的出现,急性髓系白血病(AML)的治疗方法有了很大的发展。单独或联合低剂量或高强度化疗的靶向治疗已经改善了一线治疗和复发/难治性 AML 患者的预后。尽管取得了这些进展,但异基因造血干细胞移植(allo-HCT)仍然是中间风险和不良风险以及复发/难治性疾病一线治疗后的巩固治疗的关键。然而,许多患者复发,治疗选择有限,因此需要移植后策略来降低复发风险。allo-HCT 后维持治疗就是为此目的而开发的,它可以利用直接的抗白血病作用和/或增强真正的移植物抗白血病作用,而不会增加移植物抗宿主病的风险。在本文中,我们总结了 allo-HCT 前后 AML 的新型治疗方法,并回顾了正在进行的研究。

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