成人复发难治急性髓系白血病治疗进展

Advances in the Treatment of Adult Relapsed/Refractory Acute Myeloid Leukemia

成人复发/难治急性髓细胞白血病治疗仍面临较大困难,目前尚无统一、有效的治疗方案。患者预后极差,传统的挽救性化疗缓解率较低,并且患者因为原发耐药、药物累积的毒性作用、脏器功能衰退、干细胞储备功能低、家庭经济等诸多因素,常常限制了治疗方案的选择。随着对白血病生物学特性认识的不断深入,一系列与AML发病机制和病理生理密切相关的基因、受体、抗原、细胞内关键物质等相继被发现,使得复发/难治急性髓系白血病的治疗有了更多的选择。目前针对复发难治急性髓系白血病的治疗有传统化疗、造血干细胞移植、靶向治疗、免疫治疗等。本人针对成人复发/难治急性髓系白血病治疗进展做一综述。

The treatment of adult relapsed/refractory acute myeloid leukemia still faces great difficulties, and there are no unified and effective treatment solutions. The prognosis of patients is extremely poor, and the remission rate of traditional salvage chemotherapy is low. Additionally, the choice of a treatment plan is limited due to primary drug resistance, toxic effects of accumulated drugs, decline in organ function, low stem cell reserve, family economy, and other factors. With the expansion in the understanding of the biological characteristics of leukemia, a series of genes, receptors, antigens, and key intracellular substances that are closely related to the pathogenesis and pathophysiology of AML have been discovered. This has provided more options for the treatment of relapsed/refractory acute myeloid leukemia. Current treatments for relapsed and refractory acute myeloid leukemia include traditional chemotherapy, hematopoietic stem cell transplantation, targeted therapy, and immunotherapy. In this paper, we will review the progress in the treatment of adult relapsed/refractory acute myeloid leukemia.