[分子靶向治疗急性髓性白血病]。

Yuichi Ishikawa
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引用次数: 0

摘要

急性髓性白血病(AML)是一种异质性疾病,各种染色体和遗传异常的积累在很大程度上参与了其发病和预后。近年来,基于分子异常的疾病分类和新的分子靶向治疗得到了发展。在欧洲和美国,自2017年以来,几种药物已被批准用于AML,并作为标准治疗方法纳入指南,这取决于合并症基因突变与常规化疗或单药治疗的结合。FLT3抑制剂米多舒林联合强化化疗改善了FLT3- itd阳性AML患者的预后,长期以来,FLT3- itd阳性AML患者被认为预后较差。除了小分子化合物外,各种AML新疗法正在临床研究中,包括靶向CD47和TIM-3的抗体疗法、双特异性抗体和car - t细胞疗法。考虑到多种治疗方式的治疗策略,需要明确难治性AML的发病机制和克隆选择过程,包括残余白血病细胞的周围环境。在不久的将来,新疗法和化疗的结合有望改善AML患者的预后。
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[Molecular targeted therapy for acute myeloid leukemia].

Acute myeloid leukemia (AML) is a heterogeneous disease, and the accumulation of various chromosomal and genetic abnormalities is considerably involved in its pathogenesis and prognosis. Recently, the disease classification based on molecular abnormalities and novel molecular-targeting therapies has been developed. In Europe and the United States, several agents have been approved for AML and incorporated into guidelines as the standard treatment depending on comorbid genetic mutations combined with conventional chemotherapy or monotherapy since 2017. The combination therapy of FLT3 inhibitor midostaurin and intensive chemotherapy has improved the prognosis of patients with FLT3-ITD-positive AML, which has been considered a poor prognosis for a long period. In addition to small-molecule compounds, various novel therapies for AML are under clinical investigation, including antibody therapies targeting CD47 and TIM-3, bispecific antibodies, and CAR-T-cell therapies. Considering the treatment strategies with diverse therapeutic modalities, the pathogenesis and clonal selection process of refractory AML, including the surrounding environment of residual leukemia cells, should be clarified. The combination of new therapies and chemotherapies is highly expected to improve the prognosis of patients with AML in the near future.

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