在过去的十年中，随着针对白血病细胞多种脆弱性的新疗法的批准、干细胞移植机会的扩大以及移植安全性的提高，急性髓系白血病的治疗结果得到了显着改善。虽然目前大多数接受强化或非强化诱导方案的 AML 患者获得初步缓解是预期结果，但维持长期缓解和降低复发风险仍然是关键挑战。使用各种药物的维护方法已经取得了不同程度的成功，并且直到最近才被纳入护理标准。我们提出了四种常见的临床场景，突出了医生在护理缓解期 AML 患者并考虑使用缓解后维持治疗时面临的挑战。利用已发表的研究和新出现的临床数据，我们讨论了 AML 维持治疗的方法，强调特定策略的选择是基于白血病生物学和风险分层、可靶向突变的存在、初始治疗方法、表现状态和同种异体干细胞移植的可行性。版权所有 © 2024 美国血液学会。

Outcomes for acute myeloid leukemia have improved significantly in the last decade with the approval of novel therapeutics targeting diverse vulnerabilities of leukemic cells, expanded access to stem cell transplantation, and improved safety of transplantation. While attainment of initial remission is now an expected outcome in most AML patients receiving intensive or non-intensive induction regimens, maintaining long-term remission and decreasing the risk of relapse remain critical challenges. Maintenance approaches employing assorted agents have yielded variable success and only recently have been integrated to the standard of care. We present four commonly encountered clinical scenarios that highlight challenges facing physicians as they care for AML patients in remission and contemplate using post-remission maintenance. Using published studies and emerging clinical data, we discuss our approach to maintenance treatment in AML, emphasizing that selection of a specific strategy is an individualized decision based on leukemia biology and risk stratification, presence of targetable mutations, initial treatment approach, performance status, and feasibility of allogeneic stem cell transplantation.Copyright © 2024 American Society of Hematology.