Reviews in clinical and experimental hematology最新文献_第7页

Acute myeloid leukemia: treatment over 60. 急性髓性白血病:治疗60岁以上。

Reviews in clinical and experimental hematology Pub Date : 2002-03-01 DOI: 10.1046/J.1468-0734.2002.00059.X

T. Büchner, W. Hiddemann, W. Berdel, B. Wörmann, C. Schoch, H. Löffler, T. Haferlach, A. Schumacher, P. Staib, L. Balleisen, A. Grüneisen, H. Rasche, C. Aul, A. Heyll, E. Lengfelder, W. Ludwig, G. Maschmeyer, H. Eimermacher, J. Karow, N. Frickhofen, W. Hirschmann, M. Sauerland

{"title":"Acute myeloid leukemia: treatment over 60.","authors":"T. Büchner, W. Hiddemann, W. Berdel, B. Wörmann, C. Schoch, H. Löffler, T. Haferlach, A. Schumacher, P. Staib, L. Balleisen, A. Grüneisen, H. Rasche, C. Aul, A. Heyll, E. Lengfelder, W. Ludwig, G. Maschmeyer, H. Eimermacher, J. Karow, N. Frickhofen, W. Hirschmann, M. Sauerland","doi":"10.1046/J.1468-0734.2002.00059.X","DOIUrl":"https://doi.org/10.1046/J.1468-0734.2002.00059.X","url":null,"abstract":"Undertreatment of older patients with acute myeloid leukemia (AML) can explain, in part, their inferior outcome when compared to that of younger patients. In agreement with the benefit seen by patients under age 60 from high-dose cytosine arabinoside (Ara-C), there are dose effects in the over 60s, in particular for daunorubicin, in induction treatment and for the duration of postremission treatment. The use of these effects can partly overcome the mostly unfavorable disease biology in older age AML, as expressed by the absence of favorable and the over-representation of adverse chromosomal abnormalities as well as the expression of drug resistance. We recommend an adequate dosage of 60 mg/m2 daunorubicin on 3 days in combination with standard dose Ara-C and 6-thioguanine given for induction and consolidation, and followed by a prolonged monthly maintenance chemotherapy for at least 1 year's duration. Further improvements in supportive care may help to deliver additional antileukemic cytotoxicity. As a novel approach, nonmyeloablative preparative regimens may open up the possibility of allogeneic transplantation for older patients with AML. Other new options like multidrug resistance modulators, antibody targeted therapies and molecular targeting are under clinical investigation. A questionnaire study in patients with AML showed that, according to patients' self-assessment, intensive and prolonged treatment did not result in a diminished quality of life. This finding did not vary by age, under or over 60 years. As the median age in this disease is more than 60 years, the adequate management of AML in older patients remains the major challenge.","PeriodicalId":82483,"journal":{"name":"Reviews in clinical and experimental hematology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2002-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1046/J.1468-0734.2002.00059.X","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"57744760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 35

Genetic profile of acute myeloid leukemia. 急性髓性白血病的基因图谱。

Reviews in clinical and experimental hematology Pub Date : 2002-03-01 DOI: 10.1046/J.1468-0734.2002.00060.X

C. Mecucci, R. Rosati, R. Starza

引用次数: 12

Advances in the understanding and management of acute promyelocytic leukemia. 急性早幼粒细胞白血病的认识与治疗进展。

Reviews in clinical and experimental hematology Pub Date : 2002-03-01 DOI: 10.1046/J.1468-0734.2002.00061.X

F. Mandelli, G. Avvisati, F. Lo Coco

{"title":"Advances in the understanding and management of acute promyelocytic leukemia.","authors":"F. Mandelli, G. Avvisati, F. Lo Coco","doi":"10.1046/J.1468-0734.2002.00061.X","DOIUrl":"https://doi.org/10.1046/J.1468-0734.2002.00061.X","url":null,"abstract":"Considerable progress has been made over the past decade in the understanding and management of acute promyelocytic leukemia (APL). At the laboratory level, molecular mechanisms underlying the arrest of differentiation that typically features in this malignancy, have been clarified and currently provide important models for addressing future investigation aimed at releasing the maturation block in other malignancies. In the clinic, advances in the management of APL have converted this rapidly fatal disease into the most frequently curable leukemia in adults. Use of retinoids in combinatorial protocols with anthracycline-based chemotherapy for front line treatment currently results in long-term survival and potential cure in at least 60% of newly diagnosed patients. Even after relapse, the disease is still curable in a high percentage of cases by various approaches including combinations of chemotherapy, retinoids, arsenic trioxide, stem cell transplantation and antibody-targeted chemotherapy. Genetic testing for identification of the disease-specific gene rearrangement and monitoring of residual disease have proved critical in establishing correct diagnosis and better evaluate the response to therapy at the molecular level. Current 'hot' issues for clinical investigation include: (i) better understanding and management of the severe coagulopathy present at diagnosis in most patients; (ii) the definition of risk categories to improve identification of patients at highest risk of relapse and (iii) the translation of successful differentiation therapy to other leukemia subsets.","PeriodicalId":82483,"journal":{"name":"Reviews in clinical and experimental hematology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2002-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1046/J.1468-0734.2002.00061.X","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"57744822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 22

Immunogenicity of erythropoietin and other growth factors. 促红细胞生成素和其他生长因子的免疫原性。