急性早幼粒细胞白血病病史。

Clinical Hematology International Pub Date : 2021-07-19 eCollection Date: 2021-12-01 DOI:10.2991/chi.k.210703.001
Miguel A Sanz, Eva Barragán
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引用次数: 5

摘要

在这篇文章中,我们讨论了急性早幼粒细胞白血病(APL)的历史,从治疗前的时代开始,它在1947年被Hillestad识别为一个病分学实体,到现在。这是一段将“最恶性的白血病”转变为最可治愈的白血病的典范历史。早幼粒细胞白血病基因与视黄酸受体α融合的15号和17号染色体之间平衡互惠易位的鉴定,对于理解白血病发生机制至关重要,并且对全反式视黄酸(ATRA)和三氧化二砷(ATO)靶向治疗的特殊反应负责。我们回顾了标志着连续治疗进展的里程碑,从20世纪70年代早期引入第一次成功的化疗开始,随后在20世纪80年代末和90年代初将ATRA和ATO结合使用,这彻底改变了该疾病的治疗。在过去的二十年里,治疗优化依赖于ATRA、ATO和化疗的结合,根据风险适应的方法,再加上支持治疗的改进,为大多数APL患者的治愈铺平了道路。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

History of Acute Promyelocytic Leukemia.

History of Acute Promyelocytic Leukemia.

In this article, we discuss the history of acute promyelocytic leukemia (APL) from the pre-therapeutic era, which began after its recognition by Hillestad in 1947 as a nosological entity, to the present day. It is a paradigmatic history that has transformed the "most malignant leukemia form" into the most curable one. The identification of a balanced reciprocal translocation between chromosomes 15 and 17, resulting in fusion between the promyelocytic leukemia gene and the retinoic acid receptor alpha, has been crucial in understanding the mechanisms of leukemogenesis, and responsible for the peculiar response to targeted therapy with all-trans retinoic acid (ATRA) and arsenic trioxide (ATO). We review the milestones that marked successive therapeutic advances, beginning with the introduction of the first successful chemotherapy in the early 1970s, followed by a subsequent incorporation of ATRA and ATO in the late 1980s and early 1990s which have revolutionized the treatment of this disease. Over the past two decades, treatment optimization has relied on the combination of ATRA, ATO, and chemotherapy according to risk-adapted approaches, which together with improvements in supportive therapy have paved the way for cure for most patients with APL.

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