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[小儿急性髓系白血病]

[Pediatric acute myeloid leukemia].

作者信息

Moritake Hiroshi

机构信息

Division of Pediatrics, Department of Developmental and Urological Reproductive Medicine, Faculty of Medicine, University of Miyazaki.

出版信息

Rinsho Ketsueki. 2024;65(9):928-936. doi: 10.11406/rinketsu.65.928.

Abstract

Acute myeloid leukemia (AML) accounts for approximately 25% of pediatric leukemia cases in Japan, with approximately 150 patients being newly diagnosed with AML annually. Pediatric acute myeloid leukemia is classified into three groups: myeloid leukemia associated with Down syndrome (ML-DS), acute promyelocytic leukemia (APL), and de novo AML. Patients with ML-DS have an event-free survival rate over 80%; however, relapsed patients have dismal outcomes, even if they receive hematopoietic cell transplantation. APL is curable with all-trans retinoic acid and arsenic trioxide. In de novo AML, 10% of patients fail to achieve remission, and approximately 30% of patients who successfully achieve remission subsequently experience AML relapse. This review highlights the therapeutic approach for these three diseases with context from past clinical studies in Japan, and shares promising new therapeutic options for relapsed/refractory de novo AML.

摘要

急性髓系白血病(AML)约占日本儿童白血病病例的25%,每年约有150例新诊断为AML的患者。儿童急性髓系白血病分为三组:唐氏综合征相关髓系白血病(ML-DS)、急性早幼粒细胞白血病(APL)和原发性AML。ML-DS患者的无事件生存率超过80%;然而,复发患者的预后很差,即使他们接受造血细胞移植。APL可用全反式维甲酸和三氧化二砷治愈。在原发性AML中,10%的患者未能达到缓解,成功达到缓解的患者中约30%随后会出现AML复发。本综述结合日本过去的临床研究背景,重点介绍了这三种疾病的治疗方法,并分享了复发/难治性原发性AML有前景的新治疗选择。

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