CLIN CANCER RES :儿童急性淋巴细胞白血病患者神经毒性风险和预后的差异

2018-10-30 MedSci MedSci原创

甲氨蝶呤化疗与治疗期间神经系统并发症及长期神经功能损害有关。CLIN CANCER RES近期发表了一篇文章,研究与甲氨蝶呤神经毒性发生率相关的人口统计学和临床因素,并阐述了神经毒性对儿童急性淋巴细胞白血病(ALL)患者治疗的影响。

甲氨蝶呤化疗与治疗期间神经系统并发症及长期神经功能损害有关。CLIN CANCER RES近期发表了一篇文章,研究与甲氨蝶呤神经毒性发生率相关的人口统计学和临床因素,并阐述了神经毒性对儿童急性淋巴细胞白血病(ALL)患者治疗的影响。

研究在2012年至2017年期间,从美国三个儿科肿瘤治疗中心入组患者。作者分析了疑似甲氨蝶呤神经毒性(甲氨蝶呤治疗后的急性神经系统事件)患者的病例。使用Cox比例风险模型估计种族与甲氨蝶呤神经毒性之间的关系。使用多因素线性回归模型比较了有无甲氨蝶呤神经毒性的患者之间的治疗结果差异。 在入选的280例新发患者中,39例患者(13.9%)出现甲氨蝶呤神经毒性。与非西班牙裔白人相比,西班牙裔患者甲氨蝶呤神经毒性风险最高。出现神经毒性事件的患者接受的鞘内甲氨蝶呤剂量更低。39例出现神经毒性患者中有6例(15.4%)在研究期间复发,241例(2.1%)无神经毒性的患者中有13例复发。

文章最后认为,西班牙裔与甲氨蝶呤神经毒性风险增加有关,而神经毒性风险增加与治疗改变和肿瘤复发有关。明确甲氨蝶呤神经毒性的机制和预测因素对改善儿科ALL的治疗效果非常重要。

原始出处:

Olga A. Taylor, Austin L. Brown et al. Disparities in Neurotoxicity Risk and Outcomes among Pediatric Acute Lymphoblastic Leukemia Patients. CLIN CANCER RES. October 2018 doi: 10.1158/1078-0432.CCR-18-0939

本文系梅斯医学(MedSci)原创编译整理,转载需授权!


版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (4)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1997916, encodeId=7cbc199e91636, content=<a href='/topic/show?id=75ff66001cd' target=_blank style='color:#2F92EE;'>#淋巴细胞白血病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=66001, encryptionId=75ff66001cd, topicName=淋巴细胞白血病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1be8234, createdName=sunyl07, createdTime=Sun Mar 24 19:16:00 CST 2019, time=2019-03-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1302199, encodeId=17e513021995a, content=<a href='/topic/show?id=82a6659902c' target=_blank style='color:#2F92EE;'>#淋巴细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65990, encryptionId=82a6659902c, topicName=淋巴细胞)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e34303, createdName=wetgdt, createdTime=Thu Nov 01 00:16:00 CST 2018, time=2018-11-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1484107, encodeId=7621148410e78, content=<a href='/topic/show?id=81c2e4343a9' target=_blank style='color:#2F92EE;'>#神经毒性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=74343, encryptionId=81c2e4343a9, topicName=神经毒性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=42127951174, createdName=12498cf9m37(暂无昵称), createdTime=Thu Nov 01 00:16:00 CST 2018, time=2018-11-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=350948, encodeId=8b5135094829, content=好文,值得点赞!认真学习了,把经验应用于实践,为患者解除病痛。, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRuUXgacXpPeW0x8Z3Qr9c3I2kTic4ZIpR29iaftYgkjRcbv982icYMtqANBPYBgPnOia6mVtX76qMXuc/0, createdBy=d85d1636106, createdName=lietome2, createdTime=Tue Oct 30 11:57:17 CST 2018, time=2018-10-30, status=1, ipAttribution=)]
  2. [GetPortalCommentsPageByObjectIdResponse(id=1997916, encodeId=7cbc199e91636, content=<a href='/topic/show?id=75ff66001cd' target=_blank style='color:#2F92EE;'>#淋巴细胞白血病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=66001, encryptionId=75ff66001cd, topicName=淋巴细胞白血病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1be8234, createdName=sunyl07, createdTime=Sun Mar 24 19:16:00 CST 2019, time=2019-03-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1302199, encodeId=17e513021995a, content=<a href='/topic/show?id=82a6659902c' target=_blank style='color:#2F92EE;'>#淋巴细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65990, encryptionId=82a6659902c, topicName=淋巴细胞)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e34303, createdName=wetgdt, createdTime=Thu Nov 01 00:16:00 CST 2018, time=2018-11-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1484107, encodeId=7621148410e78, content=<a href='/topic/show?id=81c2e4343a9' target=_blank style='color:#2F92EE;'>#神经毒性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=74343, encryptionId=81c2e4343a9, topicName=神经毒性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=42127951174, createdName=12498cf9m37(暂无昵称), createdTime=Thu Nov 01 00:16:00 CST 2018, time=2018-11-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=350948, encodeId=8b5135094829, content=好文,值得点赞!认真学习了,把经验应用于实践,为患者解除病痛。, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRuUXgacXpPeW0x8Z3Qr9c3I2kTic4ZIpR29iaftYgkjRcbv982icYMtqANBPYBgPnOia6mVtX76qMXuc/0, createdBy=d85d1636106, createdName=lietome2, createdTime=Tue Oct 30 11:57:17 CST 2018, time=2018-10-30, status=1, ipAttribution=)]
  3. [GetPortalCommentsPageByObjectIdResponse(id=1997916, encodeId=7cbc199e91636, content=<a href='/topic/show?id=75ff66001cd' target=_blank style='color:#2F92EE;'>#淋巴细胞白血病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=66001, encryptionId=75ff66001cd, topicName=淋巴细胞白血病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1be8234, createdName=sunyl07, createdTime=Sun Mar 24 19:16:00 CST 2019, time=2019-03-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1302199, encodeId=17e513021995a, content=<a href='/topic/show?id=82a6659902c' target=_blank style='color:#2F92EE;'>#淋巴细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65990, encryptionId=82a6659902c, topicName=淋巴细胞)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e34303, createdName=wetgdt, createdTime=Thu Nov 01 00:16:00 CST 2018, time=2018-11-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1484107, encodeId=7621148410e78, content=<a href='/topic/show?id=81c2e4343a9' target=_blank style='color:#2F92EE;'>#神经毒性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=74343, encryptionId=81c2e4343a9, topicName=神经毒性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=42127951174, createdName=12498cf9m37(暂无昵称), createdTime=Thu Nov 01 00:16:00 CST 2018, time=2018-11-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=350948, encodeId=8b5135094829, content=好文,值得点赞!认真学习了,把经验应用于实践,为患者解除病痛。, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRuUXgacXpPeW0x8Z3Qr9c3I2kTic4ZIpR29iaftYgkjRcbv982icYMtqANBPYBgPnOia6mVtX76qMXuc/0, createdBy=d85d1636106, createdName=lietome2, createdTime=Tue Oct 30 11:57:17 CST 2018, time=2018-10-30, status=1, ipAttribution=)]
  4. [GetPortalCommentsPageByObjectIdResponse(id=1997916, encodeId=7cbc199e91636, content=<a href='/topic/show?id=75ff66001cd' target=_blank style='color:#2F92EE;'>#淋巴细胞白血病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=66001, encryptionId=75ff66001cd, topicName=淋巴细胞白血病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1be8234, createdName=sunyl07, createdTime=Sun Mar 24 19:16:00 CST 2019, time=2019-03-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1302199, encodeId=17e513021995a, content=<a href='/topic/show?id=82a6659902c' target=_blank style='color:#2F92EE;'>#淋巴细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65990, encryptionId=82a6659902c, topicName=淋巴细胞)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e34303, createdName=wetgdt, createdTime=Thu Nov 01 00:16:00 CST 2018, time=2018-11-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1484107, encodeId=7621148410e78, content=<a href='/topic/show?id=81c2e4343a9' target=_blank style='color:#2F92EE;'>#神经毒性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=74343, encryptionId=81c2e4343a9, topicName=神经毒性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=42127951174, createdName=12498cf9m37(暂无昵称), createdTime=Thu Nov 01 00:16:00 CST 2018, time=2018-11-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=350948, encodeId=8b5135094829, content=好文,值得点赞!认真学习了,把经验应用于实践,为患者解除病痛。, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRuUXgacXpPeW0x8Z3Qr9c3I2kTic4ZIpR29iaftYgkjRcbv982icYMtqANBPYBgPnOia6mVtX76qMXuc/0, createdBy=d85d1636106, createdName=lietome2, createdTime=Tue Oct 30 11:57:17 CST 2018, time=2018-10-30, status=1, ipAttribution=)]
    2018-10-30 lietome2

    好文,值得点赞!认真学习了,把经验应用于实践,为患者解除病痛。

    0

相关资讯

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?

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

Blood:竺晓凡/程涛教授团队取得重大突破,揭晓FLT3为PRC2突变T-ALL潜在治疗靶点!

近日,Blood杂志发表了一项来自中国的研究,中国医学科学院血液病医院的竺晓凡/程涛教授团队成功揭晓了儿童T细胞急淋(T-ALL)的治疗靶点。该研究证实了FMS样酪氨酸激酶3(FLT3)是组蛋白甲基化酶复合物2(PRC2)突变的儿童T-ALL患者的潜在治疗靶点,这具有重要的临床价值。

Nat Rev Clin Oncol:Nature子刊颁布CAR-T疗法指南,关联儿童急性淋巴细胞白血病

去年8月,FDA批准CAR-T疗法用于治疗急性淋巴细胞白血病(ALL)。一年后,德克萨斯大学MD Anderson癌症中心联合儿科急性肺损伤和脓毒症研究者网络(PALISI)的科学家们发布了关于儿童接受CAR-T细胞治疗的全面共识指南。指南汇集顶级专家在识别治疗相关毒性的早期迹象和症状方面吸取的经验教训,并详细介绍了应对这些症状的方法。

儿童急性淋巴细胞白血病诊疗规范(2018版)

为落实国家卫生健康委、国家发展改革委、人力资源社会保障部、国家医保局、国家中医药局、国家药监局联合印发的《关于开展儿童白血病救治管理工作的通知》要求,进一步提高儿童白血病诊疗规范化水平,保障医疗质量与安全,组织制定了儿童急性淋巴细胞白血病诊疗规范(2018年版)。

NATURE:ALL使用神经迁移途径侵入CNS

急性淋巴细胞白血病(ALL)具有转移至中枢神经系统(CNS)的显着倾向。与来自实体瘤的脑转移相反,ALL的转移很少涉及实质。