老年急性髓系白血病的特点和治疗策略被引量：39

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摘要在世界范围内，每10万人中约有4人发生急性白血病[1]。急性髓系白血病（AML）约占白血病总发病人数的70％[1]。老年人造血系统以粒系造血为主[2]，因此老年AML的发生率显著升高。瑞典对本国1997至2005年登记在册的所有AML患者进行回顾性分析，显示AML的发病高峰为80—84岁[3]。随着世界人口的老龄化进展，老年AML患者将越来越多。因此老年AML的治疗也越来越受到关注。同样的化疗方案，老年AML患者的治疗效果较年轻AML患者差。英国医学研究理事会曾于1986年公布了AML8的研究结果，在1127例患者中，50岁以下AML患者缓解率约为70％，50～59岁为68％，60～69岁为53％，70—74岁为39％，而75岁及以上患者缓解率只有22％[4]。

作者王黎沈志祥

机构地区上海交通大学医学院附属瑞金医院血液科

出处《中华血液学杂志》 CAS CSCD 北大核心 2013年第1期76-79,共4页 Chinese Journal of Hematology

基金国家自然科学青年基金（81101793）上海交通大学医学院附属瑞金医院优秀青年教师培养计划

关键词急性髓系白血病治疗效果老年人英国医学研究理事会 AML 急性白血病世界范围发病人数

分类号 R733.71 [医药卫生—肿瘤]

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1Brunning RD, Matutes E, Harris NL, et al. Acute myeloid leuke-mia: introduction//World Health Organization classification oftumours : pathology & genetics, tumours of haematopoietic andlymphoid tissues. Lyon, France: International Agency for Researchon Cancer, 2001 : 77-80.
2Sudo K, Ema H, Morita Y, et al. Age-associated characteristics ofmurine hematopoietic stem cells. J Exp Med, 2000,192: 1273-1280.
3Juliusson G, Antunovic P, Derolf A, et al. Age and acute myeloidleukemia : real world data on decision to treat and outcomes fromthe Swedish Acute Leukemia Registry. Blood,2009 , 113 :4179-4187.
4Rees JK, Gray RG,Swirsky D, et al. Principal results of the Med-ical Research Council’s 8th acute myeloid leukemia trial. Lancet,1986, 2:1236-1241.
5Janzen V, Forkert R, Fleming HE, et al. Stem-cell ageing modi-fied by the cyclin-dependent kinase inhitior pl6INK4a. Nature,2006,443:421426.
6de Jonge HJ, de Bont ES,Vaik PJ, et al. AML at older age: age-related gene expression profiles reveal a paradoxical down-regula-tion of pl6INK4A mRNA with prognostic significance. Blood,2009, 114:2869-2877.
7McMurray MA, Gottschling DE. An age-induced switch to a hyper-recombinational state. Science, 2003,301 : 1908-1911.
8Rtibe CE, Fricke A,Widmann TA,et al. Accumulation of DNAdamage in hematopoietic stem and progenitor cells during humanaging. PLoS One, 2011,6:el7487.
9Kenyon J, Fu P, Lingas K, et al. Humans accumulate microsatel-lite instability with acquired loss of MLH1 protein in hematopoieticstem and progenitor cells as a function of age. Blood,2012, 120:3229-3236.
10Leith CP, Kopecky KJ, Godwin J, et al. Acute myeloid leukemiain the elderly : assessment of multidrug resistance ( MDR1 ) andcytogenetics distinguishes biologic subgroups with remarkably dis-tinct responses to standard chemotherapy. A Southwest OncologyGroup study. Blood, 1997,89:3323-3329.