Thérapeutiques ciblées dans les leucémies aiguës

The prognosis of patients with acute leukemia improved heterogeneously during last decades. Major progresses were obtained in childhood acute lymphoid leukaemia (ALL) with cure rates reaching 80%. In adults, high risk ALL are more frequent and results are less encouraging. Acute myeloid leukaemia (AML) is more frequent in adults with a median age of nearly 70 years. Progresses occurred in younger patients but only 30-40% of them are long term survivors. Therapeutic successes of retinoic acid in acute promyelocytic leukemia and more recently of imatinib in chronic myelogenous leukemia encourage the development of specific therapies targeting leukemic associated differentiation blockade or kinase spontaneous activation. Novel antileukemia therapies also include monoclonal antibodies, antiangiogenesis agents or multidrug resistance mechanisms modulation. Some promising results show the way to more effective and less toxic associations in these diseases.