急性早幼粒细胞白血病耐药机制的研究进展

Progress of drug resistance mechanisms in acute promyelocytic leukemia

全反式维甲酸（ATRA）与三氧化二砷（As2O3）作为一线药物治疗急性早幼粒细胞白血病（APL）以来,APL患者的治愈率得到显著提高.但ATRA和（或）As2O3耐药的出现成为一个严重问题.现就近年来新提出的一些耐药机制如融合基因突变、细胞信号通路异常、染色质重构复合物异常、凋亡调控异常、骨髓微环境介导耐药等方面进行综述.

Since all-trans retinoic acid （ATRA） and arsenic trioxide （As2O3） have become front-line drugs in treatment of acute promyelocytic leukemia （APL）, cure rates of APL patients have improved dramatically. However, resistance to ATRA and/or As2O3has been a critical problem which has hampered the effect of treatment. In this review, some emerging mechanisms of resistance to ATRA and/or As2O3in recent years, such as genetic mutations, disorders of cellular signal transduction, disorders of chromatin remodeling complex, abnormal regulation of cell apoptosis, and micro-environment mediated drug resistance are summarized.