老年人急性髓细胞白血病治疗研究进展

Research progress in the treatment of acute myeloid leukemia in the elderly

目的 总结并整理国内外老年人急性髓细胞白血病(AML)的治疗方法和新型药物。方法 以“acute myelogenous leukemia(AML)、acute nonlymphoblastic leukemia(ANLL)、elderly people”为关键词,检索PubMed数据库2010年1月-2024年1月发表的相关文献。纳入标准:(1)老年人AML治疗方案;(2)老年人急性非淋巴细胞白血病治疗研究;(3)相关临床试验及药物研究。排除标准:(1)样本量小或数据不全文献;(2)低质量文献;(3)内容相似或重复的文章;(4)存在争议的文章。最终纳入80篇文献。结果 目前AML的发病年龄偏大,生存率和预后偏低。为了改善老年AML的预后,国内外提出许多治疗方法且不断开展新型药物研发。部分老年患者能够承受强化化疗,部分更适合低强度治疗或支持治疗。与此同时,相比于传统化疗方案,同种异体移植和免疫策略表现出较大的潜力,许多新研发的药物也在一定程度上有很好的疗效。然而,对于老年人AML预后,目前尚无统一标准进行评价,最佳治疗方法仍有待确定,需根据老年人个体情况综合考虑,更重要的是患者自身的选择。结论 随着医疗水平和科学技术的进步,老年AML患者的生存期得以延长,对于有效治疗方法和药物的总结能为老年AML患者治疗提供新策略和新思路。

Objective To summarize the therapeutic methods and new drugs of acute myeloid leukemia(AML)in the elder-ly.Methods Taking"acute myelogenous leukemia(AML),acute nonlymphoblastic leukemia(ANLL),elderly people"as the search terms,relevant literature published in PubMed database from January 2010 to January 2024 were searched.In-clusion criteria:(1)AML treatment regimen for the elderly;(2)Research on the treatment of ANLL in the elderly;(3)Related clinical trials and drug research.Exclusion criteria:(1)Small sample size or incomplete data;(2)Low-quality lit-erature;(3)Articles with similar or repeated content;(4)Controversial articles.Finally,80 literature were included.Results At present,the incidence of AML is higher in older age groups,with lower survival rates and prognosis.In or-der to improve the prognosis of elderly AML,many therapeutic methods have been proposed at home and abroad,and new drugs have been continuously developed.Some elderly patients can withstand intensive chemotherapy,and some are more suitable for low-intensity or supportive treatment.At the same time,compared with traditional chemotherapy regi-ments,allotransplantation and immunization strategies have shown greater potential,and many newly developed drugs have also shown good efficacy to some extent.However,for the prognosis of AML in the elderly,there is no unified standard for evaluation,and the best treatment method remains to be determined,which should be comprehensively con-sidered according to the individual situation of the elderly,and more importantly,the choice of the patients themselves.Conclusions With the advancement of medical technology and science,the survival of elderly patients with AML can be extended.The summary of effective treatment methods and drugs can provide new strategies and new ideas for the treat-ment of elderly patients with AML.