Blood:急性淋巴细胞白血病青少年和年轻患者究竟该按儿科还是成人方案治疗?

2018-06-13 MedSci MedSci原创

急性淋巴细胞白血病(ALL)青少年和年轻(AYA)患者被认为是一个独特的群体,具有特定的特点和需求。很多儿科和成人合作组的对比性研究支持15-20岁的青少年完全采用儿科治疗方案。对于年轻患者,越来越多证据表明,虽然造血干细胞移植的适应征减少,但儿科来源的甚至是全儿科治疗方案也可显著改善预后,长期存活率可达70%。近十年,基于年龄分布和最小残留病灶评估,对ALL致癌全观有了更好的了解,进而提高了风险

急性淋巴细胞白血病(ALL)青少年和年轻(AYA)患者被认为是一个独特的群体,具有特定的特点和需求。很多儿科和成人合作组的对比性研究支持15-20岁的青少年完全采用儿科治疗方案。对于年轻患者,越来越多证据表明,虽然造血干细胞移植的适应征减少,但儿科来源的甚至是全儿科治疗方案也可显著改善预后,长期存活率可达70%。

近十年,基于年龄分布和最小残留病灶评估,对ALL致癌全观有了更好的了解,进而提高了风险分层。现已出现新的治疗靶点,主要是在异质的所谓的“B-other”型,特别是费城染色体样ALL亚型,需要进行深入的分子研究和靶向治疗的特异性评估。

儿童患者的良好预后之间的剩余差距存在许多其他不可被低估的因素,包括不能及时或难以获得治疗和/或进行临床试验、急性毒性增加或治疗依从性差。

应为ALL AYA患者设计纳入上述因素的特异性治疗方案,以改善该类患者群体的存活率和生活质量。

原始出处:

Nicolas Boissel and André Baruchel. Acute lymphoblastic leukemia in adolescent and young adults: treat as adults or as children? Blood  2018  :blood-2018-02-778530;  doi: https://doi.org/10.1182/blood-2018-02-778530

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    2018-06-13 虈亣靌

    认真学习.把间接经验应用到临床实践中去.然后再总结出新思路.给点赞啦

    0

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