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急性髓系白血病的分子特征与治疗模式

Molecular Features and Treatment Paradigms of Acute Myeloid Leukemia.

作者信息

Shukla Mihir, Abdul-Hay Maher, Choi Jun H

机构信息

Department of Hematology and Medical Oncology, NYU Langone Health, Perlmutter Cancer Center, New York, NY 10016, USA.

出版信息

Biomedicines. 2024 Aug 6;12(8):1768. doi: 10.3390/biomedicines12081768.

Abstract

Acute myeloid leukemia (AML) is a common hematologic malignancy that is considered to be a disease of aging, and traditionally has been treated with induction chemotherapy, followed by consolidation chemotherapy and/or allogenic hematopoietic stem cell transplantation. More recently, with the use of next-generation sequencing and access to molecular information, targeted molecular approaches to the treatment of AML have been adopted. Molecular targeting is gaining prominence, as AML mostly afflicts the elderly population, who often cannot tolerate traditional chemotherapy. Understanding molecular changes at the gene level is also important for accurate disease classification, risk stratification, and prognosis, allowing for more personalized medicine. Some mutations are well studied and have an established gene-specific therapy, including FLT3 and IDH1/2, while others are being investigated in clinical trials. However, data on most known mutations in AML are still minimal and therapeutic studies are in pre-clinical stages, highlighting the importance of further research and elucidation of the pathophysiology involving these genes. In this review, we aim to highlight the key molecular alterations and chromosomal changes that characterize AML, with a focus on pathophysiology, presently available treatment approaches, and future therapeutic options.

摘要

急性髓系白血病(AML)是一种常见的血液系统恶性肿瘤,被认为是一种与衰老相关的疾病,传统上采用诱导化疗,随后进行巩固化疗和/或异基因造血干细胞移植。最近,随着下一代测序技术的应用以及分子信息的获取,针对AML的靶向分子治疗方法已被采用。分子靶向治疗正日益受到关注,因为AML主要影响老年人群,而他们往往无法耐受传统化疗。了解基因水平的分子变化对于准确的疾病分类、风险分层和预后也很重要,有助于实现更个性化的医疗。一些突变已得到充分研究并拥有既定的基因特异性疗法,包括FLT3和IDH1/2,而其他一些突变正在临床试验中进行研究。然而,关于AML中大多数已知突变的数据仍然很少,治疗研究尚处于临床前阶段,这凸显了进一步研究和阐明涉及这些基因的病理生理学的重要性。在这篇综述中,我们旨在强调AML的关键分子改变和染色体变化,重点关注病理生理学、目前可用的治疗方法以及未来的治疗选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3e61/11351617/7625d8c0f8cd/biomedicines-12-01768-g001.jpg

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