急性髓细胞白血病的规范化治疗

doi:10.3969/j.issn.1004-583X.2021.10.003

临床荟萃 ›› 2021, Vol. 36 ›› Issue (10): 880-883.doi: 10.3969/j.issn.1004-583X.2021.10.003

• 专题:血液病诊疗关键技术转化与推广 • 上一篇下一篇

急性髓细胞白血病的规范化治疗

刘巧雪, 魏辉()

中国医学科学院血液病医院,中国医学科学院血液学研究所,天津 300020

收稿日期:2021-10-05 出版日期:2021-10-20 发布日期:2021-11-10
通讯作者: 魏辉 E-mail:weihui@ihcams.ac.cn
作者简介:魏辉,中国医学科学院血液学研究所血液病医院白血病诊疗中心,主任医师,博士生导师。国家血液系统疾病临床医学研究中心副主任,中华医学会血液学分会委员,白血病淋巴瘤学组副组长。Hematological Oncology副主编。2000年毕业于中国医科大学,获得硕士学位;2006年毕业于中国协和医科大学,获得博士学位;2010-2013年在美国国立卫生研究院从事博士后工作。主要从事白血病的基础和临床研究。
基金资助:
中国医学科学院医学与健康科技创新工程项目(2020-I2M-C&T-B-084)

Standardized treatment of acute myeloid leukemia

Liu Qiaoxue, Wei Hui()

Hospital of Hematology, Chinese Academy of Medical Sciences, Institute of Hematology, Chinese Academy of Medical Sciences, Tianjin 300020, China

Received:2021-10-05 Online:2021-10-20 Published:2021-11-10
Contact: Wei Hui E-mail:weihui@ihcams.ac.cn

摘要/Abstract

摘要：

急性髓细胞白血病(acute myelogenous leukemia, AML)是一种以原始造血细胞克隆性增殖和分化为特征的血液系统恶性疾病,属于异质性疾病,其治疗应结合患者的染色体和分子学异常情况、预后危险度分层、对化疗的耐受程度等进行综合考虑。诱导缓解的常用方案有DA、HA、HAD方案,缓解后的巩固维持治疗方案的选择应结合患者预后危险度分层进行考虑。目前,造血干细胞移植也是AML规范化治疗的重要手段之一。老年AML患者的治疗面临更严峻的挑战,针对白血病细胞特异性位点的靶向治疗成为最具前景的治疗方案,其与常规诱导化疗相结合将成为老年AML患者治疗的新策略和新思路。

关键词: 白血病,髓样,急性, 老年人, 规范化药物治疗

Abstract:

Acute myelogenous leukemia(AML), a malignant blood system disease characterized by clonal proliferation and differentiation of primitive hematopoietic cells, is classified to be a heterogeneous disease, and the treatment of AML should be comprehensively considered in combination with chromosomal and molecular abnormalities, prognosis risk classification and chemotherapy tolerance of patients. Common solutions for remission induction involve DA, HA and HAD solutions, and the selection on consolidation and maintenance therapeutic regimen after remission should be considered in combination with prognosis risks of patients. Up to now, for standardized treatment of AML, Hematopoietic stem cell transplantation is still one of the most important means. The treatment of gerontal patients with AML faces more severer challenges, and targeted therapy for specific sites of leukemia cells has become the most promising therapeutic regimen, and its combination with conventional induction chemotherapy will become emerging strategy and idea for treatment of gerontal patients with AML.

Key words: leukemia,myeloid sample,acute, aged, standardized drug therapies

中图分类号:

R733.72

刘巧雪, 魏辉. 急性髓细胞白血病的规范化治疗[J]. 临床荟萃, 2021, 36(10): 880-883.

Liu Qiaoxue, Wei Hui. Standardized treatment of acute myeloid leukemia[J]. Clinical Focus, 2021, 36(10): 880-883.

导出引用管理器 EndNote|Ris|BibTeX

链接本文: https://huicui.hebmu.edu.cn/CN/10.3969/j.issn.1004-583X.2021.10.003

https://huicui.hebmu.edu.cn/CN/Y2021/V36/I10/880

参考文献 20

[1]	Khwaja A, Bjorkholm M, Gale RE, et al. Acute myeloid leukaemia[J]. Nat Rev Dis Primers, 2016,2:16010. doi: 10.1038/nrdp.2016.10 pmid: 27159408
[2]	Yang X, Wang JX. Precision therapy for acute myeloid leukemia[J]. J Hematol Oncol, 2018,11(1):3. doi: 10.1186/s13045-017-0543-7 URL
[3]	魏辉. 成人急性髓系白血病(非急性早幼粒细胞白血病)中国诊疗指南(2017年版)[J]. 中华血液学杂志, 2017,38(3):177-182.
[4]	Sasine JP, Schiller GJ. Acute myeloid leukemia: How do we measure success?[J]. Curr Hematol Malig Rep, 2016,11(6):528-536. doi: 10.1007/s11899-016-0346-x URL
[5]	Kadia TM, Ravandi F, Cortes J, et al. New drugs in acute myeloid leukemia[J]. Ann Oncol, 2016,27(5):770-778. doi: 10.1093/annonc/mdw015 pmid: 26802152
[6]	Wei H, Wang Y, Gale RP, et al. Randomized trial of intermediate-dose cytarabine in induction and consolidation therapy in adults with acute myeloid leukemia[J]. Clin Cancer Res, 2020,26(13):3154-3161. doi: 10.1158/1078-0432.CCR-19-3433 URL
[7]	Liu J, Mi Y, Fu M, et al. Intensive induction chemotherapy with regimen containing intermediate dose cytarabine in the treatment of de novo acute myeloid leukemia[J]. Am J Hematol, 2009,84(7):422-427. doi: 10.1002/ajh.v84:7 URL
[8]	Wei H, Zhou C, Lin D, et al. Benefit of intermediate-dose cytarabine containing induction in molecular subgroups of acute myeloid leukemia[J]. Haematologica, 2020,106(5):1491-1495. doi: 10.3324/haematol.2020.267526 URL
[9]	Dohner H, Estey EH, Amadori S, et al. Diagnosis and management of acute myeloid leukemia in adults:Recommendations from an international expert panel, on behalf of the European LeukemiaNet[J]. Blood, 2010,115(3):453-474. doi: 10.1182/blood-2009-07-235358 URL
[10]	Estey EH. Growth factors in acute myeloid leukaemia[J]. Best Pract Res Clin Haematol, 2001,14(1):175-187. doi: 10.1053/beha.2000.0122 URL
[11]	Cornelissen JJ, Blaise D. Hematopoietic stem cell transplantation for patients with AML in first complete remission[J]. Blood, 2016,127(1):62-70. doi: 10.1182/blood-2015-07-604546 pmid: 26660427
[12]	Mizutani M, Hara M, Fujita H, et al. Comparable outcomes between autologous and allogeneic transplant for adult acute myeloid leukemia in first CR[J]. Bone Marrow Transplant, 2016,51(5):645-653. doi: 10.1038/bmt.2015.349 URL
[13]	Kayser S, Levis MJ. Advances in targeted therapy for acute myeloid leukaemia[J]. Br J Haematol, 2018,180(4):484-500. doi: 10.1111/bjh.15032 URL
[14]	Stone RM, Mandrekar SJ, Sanford BL, et al. Midostaurin plus chemotherapy for acute myeloid leukemia with a FLT3 Mutation[J]. N Engl J Med, 2017,377(5):454-464. doi: 10.1056/NEJMoa1614359 URL
[15]	Saleh K, Saleh NK, Kourie HR. Acute myeloid leukemia transformed to a targetable disease[J]. Future Oncol, 2020,16(14):961-972. doi: 10.2217/fon-2019-0670 URL
[16]	Schlenk RF, Döhner H. Genomic applications in the clinic use in treatment paradigm of acute myeloid leukemia[J]. Hematology Am Soc Hematol Educ Program, 2013,2013(1):324-330.
[17]	徐斌, 肖毅. 急性髓系白血病免疫治疗最新研究进展[J]. 中国实验血液学杂志, 2019,27(2):633-636.
[18]	周文, 李莉娟, 王文媛, 等. 急性髓系白血病中树突状细胞疫苗的免疫治疗[J]. 临床荟萃, 2017,32(6):549-552.
[19]	Juliusson G, Antunovic P, Derolf A, et al. Age and acute myeloid leukemia: real world data on decision to treat and outcomes from the swedish acute leukemia registry[J]. Blood, 2009,113(18):4179-4187. doi: 10.1182/blood-2008-07-172007 pmid: 19008455
[20]	Thomas X, Jeune CL. Treatment of elderly patients with acute myeloid leukemia[J]. Curr Treat Options Oncol, 2017,18(1):2. doi: 10.1007/s11864-017-0445-5 URL

急性髓细胞白血病的规范化治疗

Standardized treatment of acute myeloid leukemia

RichHTML

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

参考文献 20

相关文章 15

编辑推荐

Metrics

本文评价

[1]	王红, 金润浩. 社区老年人自我忽视的研究进展[J]. 临床荟萃, 2024, 39(2): 164-167.
[2]	刘铎, 李燕玲, 郭朝霞, 李建锋, 张惠娟, 谢萍. 左冠状动脉异常起源于主肺动脉综合征1例并文献复习[J]. 临床荟萃, 2023, 38(7): 618-622.
[3]	王友芳, 李兴超, 朱晓松, 周廷发, 张建国, 杨淑红, 相然, 张蒙蒙, 车峰远. 肾功能亢进对重症监护室老年患者注射用头孢哌酮舒巴坦钠应用疗效的预测价值[J]. 临床荟萃, 2023, 38(4): 335-339.
[4]	柴春艳, 王婷. 老年高钙血症3例并文献复习[J]. 临床荟萃, 2023, 38(2): 166-169.
[5]	陈璨, 黄永芬, 苗雨青. 老年急性髓样白血病的治疗进展[J]. 临床荟萃, 2023, 38(10): 954-960.
[6]	马洪珍, 张涛. 生物标志物评估老年慢性肾脏病患者心功能的研究进展[J]. 临床荟萃, 2022, 37(9): 855-859.
[7]	张圆, 黄涛, 王保平. 血乳酸辅助APACHEⅡ判断ICU老年重症感染患者预后的临床意义[J]. 临床荟萃, 2021, 36(7): 604-607.
[8]	张金金, 靳蕊霞, 孙伟. 高通量血液透析对老年终末期肾脏病患者衰弱的影响[J]. 临床荟萃, 2021, 36(4): 328-331.
[9]	张新卉, 谷雨萌, 王仲言, 王东来, 夏晓爽, 王林, 刘霞. 三甲医院和社区医院老年慢性病共病现状调查[J]. 临床荟萃, 2021, 36(1): 39-43.
[10]	吕雅蕾1，宋丽娜2，单玉洁1，张晓琳3a，贾金海3b. 恩度联合顺铂对老年肿瘤患者恶性腹水的疗效[J]. 临床荟萃, 2020, 35(2): 162-165.
[11]	罗迪, 王小飞, 王蕾. 冠心病患者中心动脉血压与肱动脉血压的差值及影响因素[J]. 临床荟萃, 2020, 35(12): 1089-1092.
[12]	付丛会1，陈梅1，张晓凤1，刘新立1，崔燕萍1，沈志强1，吴毅2，贾杰2，徐英1. 特殊丰富环境对长期入住护理医院老年人抑郁状态和生活质量的影响研究[J]. 临床荟萃, 2019, 34(7): 651-654.
[13]	王璐a，田蓉a，周薇a，牛建瑞a，高茂龙b. 衰弱对慢性阻塞性肺疾病急性发作再住院的影响[J]. 临床荟萃, 2019, 34(4): 321-325.
[14]	罗兰，牛敏，张楠，高政南. 脂质蓄积指数在中老年人群代谢综合征筛查中的价值[J]. 临床荟萃, 2019, 34(3): 231-236.
[15]	戴鑫1，张蕊2，赵威1，王邦茂1. 华北地区食管憩室：124 349例胃镜检查患者5年趋势分析[J]. 临床荟萃, 2019, 34(12): 1066-1071.