弥合差距:在资源有限的环境中检测Ph-Like B-Lineage ALL的成本有效策略
Dikshat Gopal Gupta1, Monika2, Neelam Varma3
1Department of Urology and Pathology, The Robert H. Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA. dixitgupta25@gmail.com.
Molecular diagnosis & therapy
|March 29, 2025
概括
费城染色体样ALL (Ph样ALL) 是儿童白血病的高风险亚型. 本次审查强调了在低收入和中等收入国家 (LMICs) 对Ph类ALL的成本有效的诊断工具的需求.
科学领域:
- 血液瘤学 血液瘤学
- 儿科血液学 儿科血液学
- 分子诊断学 分子诊断学
背景情况:
- 急性淋巴细胞白血病 (ALL) 是一个重要的儿科血液恶性瘤.
- 费城染色体样ALL (Ph样ALL) 是一种高风险亚型,缺乏BCR::ABL1融合基因,造成诊断和治疗挑战,特别是在资源有限的环境中.
- 由于成本和复杂性,目前用于Ph类ALL的诊断方法往往无法在低收入和中等收入国家 (LMICs) 获得.
研究的目的:
- 提供Ph类ALL的全面概述,重点关注发病率,遗传景观和与LMIC相关的检测策略.
- 强调在资源有限的环境中对Ph类ALL的可访问和具有成本效益的诊断工具的关键需求.
- 探索创新的诊断方法,可以改善全球患者的治疗结果.
主要方法:
- 关于Ph类ALL遗传学,诊断和治疗的现有文献的审查.
- 在LMIC中分析当前诊断技术 (例如基因表达分析,NGS) 的局限性.
- 评估新的,具有成本效益的诊断方法,如PHi-RACE分类器,使用实时定量PCR和光 in situ杂交 (FISH).
主要成果:
- 类似PH的ALL很普遍,并且与糟糕的结果有关,因此需要在LMICs改善诊断能力.
- 先进的分子技术的高成本和漫长的周转时间限制了它们在LMICs中的使用.
- 像PHi-RACE分类器这样的创新方法以较低的成本提供高灵敏度和特异性,从而可以识别有针对性的治疗方法.
结论:
- 可访问和快速的诊断工具对于改善LMIC中Ph类ALL的检测和治疗至关重要.
- 经济有效的分子诊断策略的整合对改善全球患者护理和预后具有重大前景.
- 进一步开发和实施这些工具对于在资源有限的环境中弥合诊断差距至关重要.
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