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目的:总结国内外老年急性髓系白血病(AML)的治疗现状,探讨传统化疗、造血干细胞移植及新药在老年AML治疗中的应用。方法:应用Med-line及PubMed全文数据库检索系统,以“老年、急性髓系白血病、治疗”等为关键词,检索2004-01-2011-06的相关文献。纳入标准:1)传统化疗在老年AML治疗中应用;2)老年AML造血干细胞移植;3)新药对老年AML治疗的影响。符合要求并纳入分析的文献39篇。结果:对于高强度的化疗方案,部分患者可以耐受并获得良好的治疗效果,但是部分患者接受低剂量的化疗效果更佳;异基因造血干细胞移植为老年AML提供了治愈的可能性;一系列新药的出现为治疗窗窄、耐受性差的老年AML患者提供了新的治疗方法。结论:老年AML患者对化疗药物的治疗反应及耐受性差,应选择合适的诱导缓解及巩固治疗方案。
OBJECTIVE: To summarize the current treatment of AML in elderly at home and abroad, and to explore the application of traditional chemotherapy, hematopoietic stem cell transplantation and new drugs in the treatment of senile AML. Methods: Using the Med-line and PubMed full-text database retrieval system, with the key words of “elderly, acute myeloid leukemia, treatment” and so on, the related literatures of 2004-01-2011-06 were searched. Inclusion criteria: 1) the use of traditional chemotherapy in elderly AML therapy; 2) elderly AML hematopoietic stem cell transplantation; and 3) the impact of new drugs on the treatment of elderly AML. 39 articles that meet the requirements and are included in the analysis. RESULTS: Some patients were well tolerated and receive good treatment results for high-intensity chemotherapy regimens, but some patients received better results with low-dose chemotherapy; allogeneic hematopoietic stem cell transplantation provided the possibility of healing for elderly AML; and a series of The emergence of new drugs for the treatment of narrow, poor tolerance of elderly patients with AML provides a new treatment. Conclusion: Elderly AML patients respond to chemotherapy drugs and poor tolerance, should choose the appropriate induction of remission and consolidation of treatment options.