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2016NCCN临床实践指南:急性髓系白血病(Version2.2016)

2016-07-05 MedSci MedSci原创

2016年7月,美国国家综合癌症网络(NCCN)发布了急性髓系白血病指南2016年第2版,指南更新摘要。

英文标题:NCCN Clinical Practice Guidelines in Oncology: Acute Myeloid Leukemia(Version 2. 2016)
简要介绍:2016年7月,美国国家综合癌症网络(NCCN)发布了急性髓系白血病指南2016年第2版,指南更新摘要如下:

急性白血病实验室检查和诊断(AML-1)

急性早幼粒细胞白血病诱导缓解(AML-2)

急性早幼粒细胞白血病强化治疗(AML-5)

急性早幼粒细胞白血病复发治疗(AML-6)

AML诱导缓解(年龄<60岁) (AML-7)

标准计量阿糖胞苷诱导缓解后AML的治疗(年龄<60岁)(AML-8)

大剂量阿糖胞苷诱导缓解后AML的治疗(年龄<60岁)(AML-9)

肿瘤缓解后治疗(年龄<60岁)(AML-10)

AML诱导缓解(年龄≥60岁)(AML-11)

标准计量阿糖胞苷诱导后AML的治疗(年龄≥60岁)(AML-12)

肿瘤缓解后治疗(年龄≥60岁)(AML-13)

完全强化后肿瘤监测(AML-14)

复发性或难治性AML的治疗(AML-14)

AML易发生的细胞遗传学上的改变和分子异常(AML-A)

评估和治疗中枢性白血病(AML-B)

支持治疗(AML-C)

AML缓解标准(AML-D)

治疗监测(AML-E)

复发性或难治性白血病治疗(AML-F)

部分要点概括:

AML-1:第4条更改为:“骨髓活检细胞免疫学(核型和或FISH实验)和分子筛查(KIT、FLT3-ITD、NPM1、CEBPA和其他基因突变)”

第6条“根据患者的HLA分型从兄弟姐妹或者非血缘关系的供者中挑选可能进行造血干细胞移植的供者”改为“根据患者的HLA分型挑选可能进行造血干细胞移植的供者”。

AML-2:将“低或中级危险度”更改为:“低危险度”

AML-4:将脚注aa“诱导缓解期间每天0.5mg/kg泼尼松预防复发。如果患者产生分化综合征将泼尼松改成地塞米松10mg一天两次,直到急性分化症状消失,再重新服用原剂量泼尼松。”改为“诱导缓解期间使用泼尼松预防复发。如果产生分化综合征,改服地塞米松。”

AML-6:二次缓解后治疗方案改为:“鞘内注射化疗药物预防中枢神经系统肿瘤复发(甲氨蝶呤或阿糖胞苷)”

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    2016-11-26 仁者大医
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