Blood:如何治疗费城染色体阳性的急性淋巴细胞白血病?

2018-11-17 MedSci MedSci原创

靶向特定分子事件药物的引物改变了许多恶性肿瘤的治疗模式。既往我们完全是根据DNA相互作用的细胞毒性药物来治疗白血病患者。随着对白血病细胞生理和病理机制以及其逃逸免疫监测机制的方式的了解的加深,我们很有可能开发出更有效的药物,减少对化疗的依赖,从而完成深入根除疾病的目的。对于费城染色体阳性(Ph+)的急性淋巴细胞白血病(ALL),越来越强效的酪氨酸激酶抑制剂(TKIs)的引入彻底变革了治疗方法。这类

靶向特定分子事件药物的引物改变了许多恶性肿瘤的治疗模式。既往我们完全是根据DNA相互作用的细胞毒性药物来治疗白血病患者。随着对白血病细胞生理和病理机制以及其逃逸免疫监测机制的方式的了解的加深,我们很有可能开发出更有效的药物,减少对化疗的依赖,从而完成深入根除疾病的目的。

对于费城染色体阳性(Ph+)的急性淋巴细胞白血病(ALL),越来越强效的酪氨酸激酶抑制剂(TKIs)的引入彻底变革了治疗方法。这类药物已被确定为这种疾病的任何治疗方案的基石,一线临床试验也确定了将其应用于既定模式的最佳方案。

但是,即使应用了TKIs,目前我们仍是继续依赖于细胞毒性化疗方案和异基因造血干细胞移植(alloHCT)来获得最佳长期预后。不过随着更有效的TKIs和其他新药物以及更好的监测最小/可检测的残留病灶(MRD)方法的引入,我们正在进入一个有望减少这种疾病对移植和细胞毒性化疗依赖的时代。


原始出处:

Farhad Ravandi. How I treat Philadelphia chromosome positive acute lymphoblastic leukemia.Blood 2018 :blood-2018-08-832105; doi: https://doi.org/10.1182/blood-2018-08-832105

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