如何提高儿童急性髓系白血病的疗效

Strategies to improve therapeutic efficacy in childhood acute myeloid leukemia

摘要:

儿童急性髓系白血病（acute myelogenous leukemia，AML）是儿童急性白血病的少见类型，以往认为其疗效较儿童急性淋巴细胞白血病差。但近十年来发达国家AML 的治疗疗效显著提高，5 年无事件生存率接近70%，这归功于以危险度为基础的分层治疗、以疾病生物学特征为依据的针对性治疗和不断完善的支持治疗。精确诊断是危险度分层、评估预后、指导治疗的前提，如何减低早期病死率以提高总体生存率、如何实施恰当支持治疗以减少治疗相关并发症和降低治疗相关病死率是提高儿童AML 疗效的关键。

Abstract:

Acute myeloid leukemia (AML) is a rare type of childhood acute leukemia, which has a worse prognosis than childhood acute lymphoblastic leukemia. Over the past decade, significant progress has been made in the treatment of childhood AML and the 5-year event-free survival rate may be as high as 70% in developed countries. This survival improvement is largely attributable to risk-stratified treatments, therapies tailored to individual patients based on the biological characteristics of the disease, and continuously improving supportive care. An accurate diagnosis is the prerequisite for risk stratification, prognostic evaluation and therapeutic decision making. How to reduce early mortality and thus improve overall survival, how to implement appropriate supportive treatment to reduce treatment-associated complications, and how to reduce treatment-related mortality are the key to the improvement of therapies for childhood acute myeloid leukemia.