文章：

急性早幼粒细胞白血病：我们从哪里开始，现在身处何处，以及未来展望

Acute promyelocytic leukemia: where did we start, where are we now, and the future

原文发布日期：2015-04-17

DOI: 10.1038/bcj.2015.25

类型: Review

开放获取: 是

英文摘要：

Historically, acute promyelocytic leukemia (APL) was considered to be one of the most fatal forms of acute leukemia with poor outcomes before the introduction of the vitamin A derivative all-trans retinoic acid (ATRA). With considerable advances in therapy, including the introduction of ATRA initially as a single agent and then in combination with anthracyclines, and more recently by development of arsenic trioxide (ATO)-containing regimens, APL is now characterized by complete remission rates of 90% and cure rates of ∼80%, even higher among low-risk patients. Furthermore, with ATRA–ATO combinations, chemotherapy may safely be omitted in low-risk patients. The disease is now considered to be the most curable subtype of acute myeloid leukemia (AML) in adults. Nevertheless, APL remains associated with a significant incidence of early death related to the characteristic bleeding diathesis. Early death, rather than resistant disease so common in all other subtypes of AML, has emerged as the major cause of treatment failure.

摘要翻译： 

历史上，在维生素A衍生物全反式维甲酸（ATRA）问世之前，急性早幼粒细胞白血病（APL）曾被视作预后极差、致死率最高的急性白血病类型之一。随着治疗手段的重大进展——包括最初将ATRA作为单药使用，随后与蒽环类药物联用，以及近年来含三氧化二砷（ATO）方案的开发——如今APL的完全缓解率已达到90%，治愈率约80%，在低危患者中甚至更高。此外，对于低危患者，采用ATRA-ATO联合方案可安全地省略化疗。该病现已被认为是成人急性髓系白血病（AML）中最可治愈的亚型。然而，APL仍与特征性出血素质相关的早期死亡显著发生率密切相关。早期死亡（而非其他AML亚型中常见的耐药问题）已成为治疗失败的主要原因。

原文链接：

Acute promyelocytic leukemia: where did we start, where are we now, and the future