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-  2018 

急性髓系白血病精准治疗:新的焦点

DOI: 10.16781/j.0258-879x.2018.05.0465

Keywords: 急性髓系白血病 精准治疗 微小残留病 异基因造血干细胞移植
acute myeloid leukemia precision treatment minimal residual disease allogeneic stem cell transplantation

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Abstract:

急性白血病是35岁以下青壮年人群中发病率和病死率最高的恶性肿瘤,尽管近年来以细胞和分子遗传学为依据的分层化学治疗方案在一定程度上改善了患者的总生存率,但中危组患者常规化学治疗3年总生存率仅为30%~40%。我们基于白血病干细胞和造血干细胞的竞争,利用流式细胞术联合荧光免疫原位杂交技术检测白血病干细胞,能提前2~3个月发现患者的复发趋势,从而进行早期干预,以提高患者的生存率。此外,在造血干细胞移植中,我们设计了新型预处理方案以平衡移植物抗宿主病和移植物抗白血病效应,降低了移植相关病死率。这是急性白血病整体治疗中新的关注焦点,也是精准治疗在血液病领域的进一步延伸。
Acute leukemia is a malignant tumor with the highest morbidity and mortality in patients younger than 35 years old. Three-year overall survival of middle-risk patients receiving conventional chemotherapy is only 30%-50%, although the stratified chemotherapy based on cell and molecular genetics has improved the overall survival in recent years. To further optimize the treatment, we used flow cytometry in combination with fluorescent in situ hybridization to detect the competing of leukemia stem cells with hemopoietic stem cell, which could diagnose the relapse of patients 2-3 months ahead of time, thus allowing early intervention and improving the survival rate. In allogeneic hematopoietic stem cell transplantation, we have designed a novel conditioning regimen, which balanced the graft-versus-host disease and graft-versus-leukemia effect and reduced transplant-related mortality. This is a new focus on acute leukemia treatment and a further extension of precision therapy in leukemia

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