Jalaja Potluri，M.D.和Su Young Kim，M.D。两者都花了他们早期的职业生涯，治疗患有急性髓细胞白血病患者。但由于他们的患者的年龄，这需要两个非常不同的经历。
现在，两位医生都担心肿瘤科学研究人员坐下来深入谈论对具有这种难以血统患者的儿科和老年人患者的挑战和机会 - 以及为什么每个人口都需要新的选择。
无论是年轻人还是急性髓性白血病的年龄。两位医生讨论了原因。
Su Young Kim，M.D：告诉我成年AML患者怎么办?因为我是儿科医生，我知道孩子们在做什么，但是…
Jalaja Potluri，M.D：当然，所以，成年人中的AML，由和大，中位数年龄在他们的六十年代，所以大多数患者六十年代都无法接受标准的密集疗法。当你真正看待他们的长期结果时，65岁以上的患者做得非常差。事实上，在这个年龄段的过去三十年中，他们的长期生存没有任何改变，而不是他们的幸存者非常好的患者。他们约为40％到50％。告诉我孩子们如何与AML有关？
金：我们做得很好。所以，大约30年前，它可能在你现在所处的景观中，与这些孩子的生存率约为20％。只有在过去的10到15年里，我们实际上只有高达60％的数字，所以现在诊断时它有所不同。你谈论你知道，你要去上大学，你的生活中的计划是什么，我们保持活力，所以他们可以在你经历这种激烈的化疗时观看。我认为你有同样的问题我们所做的......我们做得很好地清除身体中的所有疾病细胞。几乎没有可检测的AML，这就像90％的患者。但我们知道他们正在重新运用，所以约有30％到40％的患者将重新发布。It’s got to be something about that stem cell, the one cell, the one to two cells that actually making all these AML cells, and I think that’s where we need to improve in the next 30 years or so, to figure out how to get rid of that, to actually make the overall survival much higher.
Potluri:Adult patients generally have a multitude of medical problems, so when you’re looking at the newly diagnosed patient with AML, they tend to have their co-morbidities, so you are looking at the physical characteristics of the patient, (and) you are also looking at the biology of the disease of AML. So by and large, patients with adult AML are not offered intensive therapy, due to their other co-existing medical conditions, and when you look at the disease biology, these patients tend to have higher aggressive features at a higher rate, such as complex cytogenetics, or less favorable chromosomal abnormalities, and up to a third of the patients also have secondary AML, meaning they had a pre-existing blood or bone marrow condition, that has, over time, emerged and transformed to become AML. It’s those disease biology characteristics that make it challenging for these patients, and particularly adult AML patients, to receive good therapy and have good outcomes.
金：孩子们非常有弹性。我认为人们对他们的看法相当虚弱，更容易受到攻击，这是一个术语，我实际适用于你人口的患者：祖父和祖母。但是 - 对待孩子的最好的事情是他们会听你的。他们听父母，他们听你的倾听。And if you think it’s necessary for them, they will tough it out and they will do whatever’s necessary… obviously there are a lot of concerns: it’s emotional, a lot of it is emotional disturbances because of all of the emergencies that come on, while they’re in this hospital; they can’t do a thing, can’t go outside and play, which is one of the biggest things that they complain about.
Potluri:正如我们了解疾病的生物学一样，AML中存在许多靶向剂。事实上，AML最近有一些批准。These, while these are important for patients with those specific abnormalities or mutations if you will, there’s other applications, so these agents can be combined potentially with the available therapy or low-intensive therapy, and to have better outcomes, so the field has changed tremendously and there are several other new agents that are being studied.
金：你知道，我们同样对这些代理商感到兴奋。我们的希望是我们可以减少我们给予新代理人的化疗量;保持相同的水平，抗AML活动，但大大减少了毒性。因此，我们对未来非常兴奋。
Jalaja Potluri，M.D：当然，所以，成年人中的AML，由和大，中位数年龄在他们的六十年代，所以大多数患者六十年代都无法接受标准的密集疗法。当你真正看待他们的长期结果时，65岁以上的患者做得非常差。事实上，在这个年龄段的过去三十年中，他们的长期生存没有任何改变，而不是他们的幸存者非常好的患者。他们约为40％到50％。告诉我孩子们如何与AML有关？
金：我们做得很好。所以，大约30年前，它可能在你现在所处的景观中，与这些孩子的生存率约为20％。只有在过去的10到15年里，我们实际上只有高达60％的数字，所以现在诊断时它有所不同。你谈论你知道，你要去上大学，你的生活中的计划是什么，我们保持活力，所以他们可以在你经历这种激烈的化疗时观看。我认为你有同样的问题我们所做的......我们做得很好地清除身体中的所有疾病细胞。几乎没有可检测的AML，这就像90％的患者。但我们知道他们正在重新运用，所以约有30％到40％的患者将重新发布。It’s got to be something about that stem cell, the one cell, the one to two cells that actually making all these AML cells, and I think that’s where we need to improve in the next 30 years or so, to figure out how to get rid of that, to actually make the overall survival much higher.
Potluri:Adult patients generally have a multitude of medical problems, so when you’re looking at the newly diagnosed patient with AML, they tend to have their co-morbidities, so you are looking at the physical characteristics of the patient, (and) you are also looking at the biology of the disease of AML. So by and large, patients with adult AML are not offered intensive therapy, due to their other co-existing medical conditions, and when you look at the disease biology, these patients tend to have higher aggressive features at a higher rate, such as complex cytogenetics, or less favorable chromosomal abnormalities, and up to a third of the patients also have secondary AML, meaning they had a pre-existing blood or bone marrow condition, that has, over time, emerged and transformed to become AML. It’s those disease biology characteristics that make it challenging for these patients, and particularly adult AML patients, to receive good therapy and have good outcomes.
金：孩子们非常有弹性。我认为人们对他们的看法相当虚弱，更容易受到攻击，这是一个术语，我实际适用于你人口的患者：祖父和祖母。但是 - 对待孩子的最好的事情是他们会听你的。他们听父母，他们听你的倾听。And if you think it’s necessary for them, they will tough it out and they will do whatever’s necessary… obviously there are a lot of concerns: it’s emotional, a lot of it is emotional disturbances because of all of the emergencies that come on, while they’re in this hospital; they can’t do a thing, can’t go outside and play, which is one of the biggest things that they complain about.
Potluri:正如我们了解疾病的生物学一样，AML中存在许多靶向剂。事实上，AML最近有一些批准。These, while these are important for patients with those specific abnormalities or mutations if you will, there’s other applications, so these agents can be combined potentially with the available therapy or low-intensive therapy, and to have better outcomes, so the field has changed tremendously and there are several other new agents that are being studied.
金：你知道，我们同样对这些代理商感到兴奋。我们的希望是我们可以减少我们给予新代理人的化疗量;保持相同的水平，抗AML活动，但大大减少了毒性。因此，我们对未来非常兴奋。
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