Department of Leukemia, UT MD Anderson Cancer Center, Houston, TX, USA.
Department of Medicine, Duke University School of Medicine, Durham, NC, USA.
Lancet. 2023 Jun 17;401(10393):2073-2086. doi: 10.1016/S0140-6736(23)00108-3. Epub 2023 Apr 15.
Progress in acute myeloid leukaemia treatment is occurring at an unprecedented pace. The past decade has witnessed an increasingly improved scientific understanding of the underlying biology of acute myeloid leukaemia, leading to enhanced prognostication tools and refined risk assessments, and most especially incorporating measurable residual disease (MRD) into longitudinal risk assessments. The classification of acute myeloid leukaemia has recently been updated by WHO and the International Consensus Classification (ICC). Recommendations for prognostic stratification, response assessment, and MRD determination have also been updated by the European LeukemiaNet. Treatment options have evolved substantially in the last 5 years for patients with newly diagnosed acute myeloid leukaemia, leading to improved outcomes in intensively treated patients and those more appropriate for non-intensive chemotherapy. More effective targeted treatment options in the relapsed setting are also available, further advancing the treatment armamentarium and improving patient outcomes.
急性髓系白血病的治疗进展正以前所未有的速度推进。过去十年见证了对急性髓系白血病基础生物学的科学认识不断提高,从而增强了预后工具和精细的风险评估,特别是将可测量残留疾病(MRD)纳入纵向风险评估。世界卫生组织(WHO)和国际共识分类(ICC)最近更新了急性髓系白血病的分类。欧洲白血病网(ELN)也更新了预后分层、反应评估和 MRD 确定的建议。在过去的 5 年中,新诊断的急性髓系白血病患者的治疗选择发生了重大变化,导致强化治疗患者和更适合非强化化疗的患者的结局得到改善。在复发环境中也有更有效的靶向治疗选择,进一步推进了治疗手段,改善了患者的结局。
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