Tisch Cancer Institute, Division of Hematology/Oncology, Icahn School of Medicine at Mount Sinai, One Gustave L Levy Place, Box 1079, New York, NY 10029, USA.
Department of Pharmacy Practice, The Mount Sinai Hospital, New York, NY 10029, USA.
Blood Rev. 2023 Nov;62:101117. doi: 10.1016/j.blre.2023.101117. Epub 2023 Jul 25.
Core binding factor acute myeloid leukemia (CBF AML), defined by t(8;21) or inv(16), is a subset of favorable risk AML. Despite its association with a high complete remission rate after induction and relatively good prognosis overall compared with other subtypes of AML, relapse risk after induction chemotherapy remains high. Optimizing treatment planning to promote recurrence free survival and increase the likelihood of survival after relapse is imperative to improving outcomes. Recent areas of research have included evaluation of the role of gemtuzumab in induction and consolidation, the relative benefit of increased cycles of high dose cytarabine in consolidation, the utility of hypomethylating agents and kinase inhibitors, and the most appropriate timing of stem cell transplant. Surveillance with measurable residual disease testing is increasingly being utilized for monitoring disease in remission, and ongoing investigation seeks to determine how to use this tool for early identification of patients who would benefit from proceeding to transplant. In this review, we outline the current therapeutic approach from diagnosis to relapse while highlighting the active areas of investigation in each stage of treatment.
核心结合因子急性髓系白血病（CBF-AML），定义为 t（8；21）或 inv（16），是一种有利风险 AML 的亚型。尽管与诱导后高完全缓解率相关，并且与其他 AML 亚型相比总体预后较好，但诱导化疗后复发风险仍然很高。优化治疗计划以促进无复发生存并增加复发后的生存机会对于改善结局至关重要。最近的研究领域包括评估 gemtuzumab 在诱导和巩固治疗中的作用、增加巩固治疗中大剂量阿糖胞苷周期的相对益处、去甲基化剂和激酶抑制剂的效用，以及干细胞移植的最佳时机。随着可测量残留疾病检测的应用，越来越多地用于监测缓解期的疾病，正在进行的研究旨在确定如何利用该工具早期识别从移植中受益的患者。在这篇综述中，我们概述了从诊断到复发的当前治疗方法，同时强调了治疗每个阶段的活跃研究领域。
