老年急性髓系白血病治疗研究进展

Advances in the Treatment of Senile Acute Myeloid Leukemia

摘要: 急性髓系白血病是一种以髓系组细胞克隆性增殖失调的恶性血液疾病，具有高度异质性，死亡率高的特征。AML可发生于任何年龄段，随着老龄化发展的趋势，发病率随着年龄增长而增加，确诊时中位年龄约在70岁。AML自然病程短，仅2~3个月，预后较差，因此，早期的干预与合适的治疗对患者预后生存极其重要。单用常规化疗对于高龄、合并症、感染的患者疗效欠佳，可联合靶向治疗、中医药，增强化疗效应、提高药物敏感性、减轻骨髓抑制和降低出血、感染不良反应。此外，微移植与常规诱导化疗方案相比，可显著提高预后生存率及生活质量，减少移植后出现的排异反应，具有广阔的临床应用前景。本文就目前老年AML治疗进展进行综述。

Abstract: Acute myeloid leukemia (AML) is a malignant blood disease characterized by dysclonal prolifera-tion of myeloid cells. It is characterized by high heterogeneity and high mortality. AML can occur at any age, and with the trend of aging, the incidence increases with age, with the median age at diag-nosis being about 70 years. The natural course of AML is short, only 2~3 months, and the prognosis is poor. Therefore, early intervention and appropriate treatment are extremely important for the prognosis and survival of patients. Conventional chemotherapy alone has poor efficacy for elderly patients, patients with complications and infections, but it can be combined with targeted therapy and traditional Chinese medicine to enhance the effect of chemotherapy, improve drug sensitivity, reduce bone marrow suppression and reduce adverse reactions of bleeding and infection. In addi-tion, compared with conventional induction chemotherapy, microtransplantation can significantly improve the prognostic survival rate and quality of life, and reduce the rejection reaction after transplantation, which has a broad clinical application prospect. This article reviews the progress in the treatment of AML in the elderly.