'Acute myeloid leukemia: a comprehensive review and 2016 update'.

'Acute myeloid leukemia: a comprehensive review and 2016 update'.
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《急性髓系白血病:全面综述与2016年最新进展》

DOI:
10.1038/bcj.2016.50
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发表时间:
2016-07-01
影响因子:
12.8
通讯作者:
Abdul-Hay M
Abdul-Hay M
中科院分区:
医学1区
文献类型:
--
作者:
De Kouchkovsky I;Abdul-Hay M

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急性髓性白血病(AML)是成人中最常见的急性白血病,仅在美国每年的发病率就超过2万例。大量染色体易位以及参与造血增殖和分化的基因突变导致低分化骨髓细胞的积累。AML是一种高度异质性的疾病;尽管病例可以根据其细胞遗传学特征分为有利、中等和不利风险组,但这些类别的预后差异很大。发现复发性基因突变,如FLT3-ITD、NMP1和CEBPA,有助于改善个体预后和指导治疗。尽管在支持治疗方面取得了进展,但治疗的骨干仍然是阿糖胞苷和蒽环类药物为基础的方案与异体干细胞移植相结合。老年患者往往无法忍受这种治疗方案,而且预后特别差。在这里,我们回顾了AML治疗的最新进展。
Acute myeloid leukemia (AML) is the most common acute leukemia in adults, with an incidence of over 20 000 cases per year in the United States alone. Large chromosomal translocations as well as mutations in the genes involved in hematopoietic proliferation and differentiation result in the accumulation of poorly differentiated myeloid cells. AML is a highly heterogeneous disease; although cases can be stratified into favorable, intermediate and adverse-risk groups based on their cytogenetic profile, prognosis within these categories varies widely. The identification of recurrent genetic mutations, such as FLT3-ITD, NMP1 and CEBPA, has helped refine individual prognosis and guide management. Despite advances in supportive care, the backbone of therapy remains a combination of cytarabine- and anthracycline-based regimens with allogeneic stem cell transplantation for eligible candidates. Elderly patients are often unable to tolerate such regimens, and carry a particularly poor prognosis. Here, we review the major recent advances in the treatment of AML.
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