急性淋巴细胞白血病
Florent Malard1, Mohamad Mohty1
1Department of Clinical Hematology and Cellular Therapy, Saint-Antoine Hospital, AP-HP, Sorbonne University, Paris, France; Sorbonne University, INSERM, Saint-Antoine Research Centre, Paris, France.
Lancet (London, England)
|April 6, 2020
概括
急性淋巴细胞白血病 (ALL) 影响儿童和成人,遗传变化影响预后. 风险分层和免疫疗法的进步为改善治疗结果提供了希望.
科学领域:
- 血液学
- 癌症学
- 遗传学
背景情况:
- 急性淋巴细胞白血病 (ALL) 是儿童和成人常见的癌症,其特征是淋巴细胞前体细胞的遗传变化.
- 染色体异常和遗传变化是ALL的关键预后指标.
- 目前的治疗改善了年轻患者的预后,但老年人和复发或耐药性疾病患者的预后不佳.
研究的目的:
- 总结目前对急性淋巴细胞白血病 (ALL) 发病,预后和治疗的了解.
- 突出遗传因素和风险分层对ALL结果的影响.
- 讨论针对ALL的新兴免疫治疗策略.
主要方法:
- 对急性淋巴细胞白血病 (ALL) 流行病学,遗传学和治疗结果的现有文献的审查.
- 预后因素的分析,包括染色体异常和遗传变化.
- 检查包括化疗和免疫疗法在内的当前和新型治疗方法.
主要成果:
- 遗传变化对于细胞分化和增殖至关重要.
- 风险分层和强化化疗改善了结果,特别是在儿童和年轻成人ALL.
- 老年人和复发性/耐药性ALL患者的结局仍然具有挑战性.
结论:
- 遗传变化对ALL的发病和预后至关重要,指导风险分层和治疗强度.
- 虽然化疗改善了结果,但新型免疫疗法如CAR T细胞和单克隆抗体代表了ALL治疗的未来.
- 对免疫治疗策略的进一步研究对于改善所有ALL患者群体的存活率至关重要,特别是老年人和耐药患者.
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