Sackstein Paul, Williams Alexis, Zemel Rachel, Marks Jennifer A, Renteria Anne S, Rivero Gustavo
Lombardi Cancer Institute, School of Medicine, Georgetown University, Washington, DC 20007, USA.
Department of Medicine, New York University, New York, NY 10016, USA.
Biomedicines. 2024 Apr 29;12(5):975. doi: 10.3390/biomedicines12050975.
The management of elderly patients diagnosed with acute myelogenous leukemia (AML) is complicated by high relapse risk and comorbidities that often preclude access to allogeneic hematopoietic cellular transplantation (allo-HCT). In recent years, fast-paced FDA drug approval has reshaped the therapeutic landscape, with modest, albeit promising improvement in survival. Still, AML outcomes in elderly patients remain unacceptably unfavorable highlighting the need for better understanding of disease biology and tailored strategies. In this review, we discuss recent modifications suggested by European Leukemia Network 2022 (ELN-2022) risk stratification and review recent aging cell biology advances with the discussion of four AML cases. While an older age, >60 years, does not constitute an absolute contraindication for allo-HCT, the careful patient selection based on a detailed and multidisciplinary risk stratification cannot be overemphasized.
老年急性髓系白血病（AML）患者的管理因高复发风险和合并症而变得复杂，这些合并症常常使患者无法接受异基因造血细胞移植（allo-HCT）。近年来，美国食品药品监督管理局（FDA）快速批准药物重塑了治疗格局，患者生存率虽有适度但颇具前景的改善。尽管如此，老年AML患者的预后仍然差强人意，这凸显了深入了解疾病生物学和制定针对性策略的必要性。在本综述中，我们讨论了欧洲白血病网络2022（ELN-2022）风险分层建议的最新修订内容，并通过讨论4例AML病例来回顾衰老细胞生物学的最新进展。虽然年龄大于60岁并非allo-HCT的绝对禁忌证，但基于详细的多学科风险分层进行谨慎的患者选择再怎么强调都不为过。
