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首页> 外文期刊>Oncology >Management of acute promyelocytic leukemia: implications for treatment of other cancers.
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Management of acute promyelocytic leukemia: implications for treatment of other cancers.

机译：急性早幼粒细胞白血病的管理：对其他癌症的治疗意义。

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The article by Drs. Stein and Tallman is an excellent summary indicating that several different approaches may lead to the ture of acute promyelocytic leukemia (APL). The goal then becomes to use the treatment least likely to be associated with short-term or long-term toxicity. The principal short-term toxic-ity of standard therapy (all-trans retinoic acid [ATRA] + anthracyclines, hereafter referred to as "AIDA") is treatment-related mortality (TRM) occurring during post-remission therapy. Such TRM has been reported to occur in 19% of patients older than 60 years.[l] It is in these patients that arsenic trioxide (ATO) + ATRA is potentially most useful. Indeed, the ongoing European trial (E Lo Coco, chair) randomizing newly diagnosed patients between AIDA and ATO+ATRA is limited to patients younger than 60 years of age, with older patients receiving ATO+ATRA. A long-term toxicity observed in about 1% of patients followed for a median of 51 months is development of myelodysplastic syndrome (MDS).[2] While it is plausible that MDS is part of the natural history of cured APL, MDS in this setting is probably more attributable to anthracyclines, which are well known to be associated with secondary MDS and acute myelocytic leukemia (AML).
机译：Drs。的文章Stein和Tallman是一个极好的总结，表明几种不同的方法可能导致急性早幼粒细胞白血病（APL）。然后的目标是使用最不可能与短期或长期毒性相关的治疗方法。标准疗法（全反式维甲酸[ATRA] +蒽环类药物，以下称为“ AIDA”）的主要短期毒性是缓解后治疗期间发生的与治疗有关的死亡率（TRM）。据报道，这种TRM在60岁以上的患者中发生19％。[l]在这些患者中，三氧化二砷（ATO）+ ATRA可能是最有用的。确实，正在进行的欧洲试验（E Lo Coco，主席）在AIDA和ATO + ATRA之间对新诊断的患者进行随机分组，仅限于60岁以下的患者，老年患者接受ATO + ATRA。骨髓增生异常综合症（MDS）的发展是在大约1％的患者中观察到的长期毒性，中位时间为51个月。[2]虽然MDS可能是治愈的APL的自然史的一部分，但在这种情况下，MDS可能更可能归因于蒽环类药物，后者与继发性MDS和急性粒细胞白血病（AML）有关。

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