摘要
急性髓细胞白血病(AML)是成年人中最常见的一类白血病, 其标准诱导化疗方案为阿糖胞苷联合蒽环类药物的"7+3"方案, 诱导缓解后, 可采取大剂量阿糖胞苷为主的巩固化疗。但是, 部分患者经标准诱导化疗不能达到完全缓解(CR), 而部分达到CR者最终复发并进展为难治性AML, 因此化疗对其疗效有限。老年及体能状态不佳患者通常无法耐受标准诱导及巩固化疗的不良反应, 其疗效更差。随着精准诊断及靶向治疗的发展, 化疗联合分子靶向药物治疗有望改善AML患者的预后。组蛋白去乙酰化酶抑制剂(HDACI)通过表观遗传学修饰, 调控靶基因及蛋白表达, 从而影响AML细胞增殖、凋亡及耐药, 但对正常细胞的毒性较小, 在AML靶向治疗领域具有一定的临床应用前景。笔者拟就HDACI治疗AML的最新研究进展进行总结, 旨在探讨HDACI在AML患者治疗中的临床应用价值。
Acute myeloid leukemia(AML)is a common type of leukemia in adults.The"7+3"regimen including cytarabine and anthracyclines is the standard induction therapy of AML,and the post-remission treatment is consolidation therapy with high-dose cytarabine as the mainstay.However,some patients cannot achieve completely remission(CR)after standard induction chemotherapy,and some patients who achieve CR will relapse and finally evolve into refractory AML,and chemotherapy has limited efficacy for them.Furthermore,remission induction and consolidation chemotherapy have certain adverse effects so that it is usually intolerable for elderly and frail patients,which leads to their worse efficacy.With the development of precise diagnosis and targeted therapy,chemotherapy combined with molecular targeted therapy is expected to improve the prognosis of some patients with AML.Histone deacetylase inhibitors(HDACI)can regulate expression of target genes and proteins through epigenetic modification,thereby effecting the proliferation,apoptosis and drug resistance of AML cells.Moreover,HDACI is less toxic to normal cells than chemotherapy drugs.Therefore,HDACI has certain clinical application prospects in the field of AML targeted therapy.This article will expound on the latest research progress of HDACI in treatment of AML,aiming to explore clinical application value of HDACI in AML treatment.
作者
黄芸
江雪杰
Huang Yun;Jiang Xuejie(epartment of Hematology,Nanfang Hospital,Southern Medical University,Guangzhou 510515,Guangdong Province,China)
出处
《国际输血及血液学杂志》
CAS
2022年第5期383-387,共5页
International Journal of Blood Transfusion and Hematology
基金
国家自然科学基金(82170165)
广东省自然科学基金(2021A1515011437)。
