کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
5664155 1590707 2017 15 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Frontline treatment of acute myeloid leukemia in adults
ترجمه فارسی عنوان
درمان سریع لوسمی حاد میلوئید در بزرگسالان
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی هماتولوژی
چکیده انگلیسی


- AML is a remarkably heterogeneous disease.
- Novel treatment strategies improved outcomes in selected genetic subsets of AML.
- Higher dose Ara-C based regimens showed to be superior over “7 + 3” regimens.
- Most centers still use “7 + 3” regimen and greater awareness will improve the outcome.

Recent years have highlighted significant progress in understanding the underlying genetic and epigenetic signatures of acute myeloid leukemia(AML). Most importantly, novel chemotherapy and targeted strategies have led to improved outcomes in selected genetic subsets. AML is a remarkably heterogeneous disease, and individualized therapies for disease-specific characteristics (considering patients' age, cytogenetics, and mutations) could yield better outcomes. Compared with the historical 5-to 10-year survival rate of 10%, the survival of patients who undergo modern treatment approaches reaches up to 40-50%, and for specific subsets, the improvements are even more dramatic; for example, in acute promyelocytic leukemia, the use of all-trans retinoic acid and arsenic trioxide improved survival from 30 to 40% up to 80 to 90%. Similar progress has been documented in core-binding-factor-AML, with an increase in survival from 30% to 80% upon the use of high-dose cytarabine/fludarabine/granulocyte colony-stimulating factor combination regimens. AML treatment was also recently influenced by the discovery of the superiority of regimens with higher dose Ara-C and nucleoside analogues compared with the “7 + 3”regimen, with about a 20% improvement in overall survival. Despite these significant differences, most centers continue to use the “7 + 3” regimen, and greater awareness will improve the outcome. The discovery of targetable molecular abnormalities and recent studies of targeted therapies (gemtuzumab ozagomycin, FLT3 inhibitors, isocitrate dehydrogenase inhibitors, and epigenetic therapies), future use of checkpoint inhibitors and other immune therapies such as chimeric antigen receptor T-cells, and maintenance strategies based on the minimal residual disease evaluation represent novel, exciting clinical leads aimed to improve AML outcomes in the near future.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Critical Reviews in Oncology/Hematology - Volume 110, February 2017, Pages 20-34
نویسندگان
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