Children's Hospital & Research Center Oakland, CA 94609, USA.
Curr Hematol Malig Rep. 2010 Oct;5(4):185-91. doi: 10.1007/s11899-010-0063-9.
Although the vast majority of children with acute lymphocytic leukemia attain remission with modern therapies, an unacceptably high number will suffer a disease relapse. Both the duration of remission and the site of relapse are important prognostic factors. This review focuses on leukemic relapse isolated to sites outside the bone marrow (extramedullary sites). Data from cooperative study groups as well as large single institutions are reviewed with respect to the incidence of isolated extramedullary relapse as well as the outcome following relapse. The unique anatomic and physiologic properties of the testes and the central nervous system-the two most common sites of isolated extramedullary relapse-are discussed. Finally, the evolution of leukemia therapy is reviewed, bringing into focus the goals and challenges of future therapeutic endeavors.
尽管绝大多数急性淋巴细胞白血病患儿通过现代疗法可达到缓解，但仍有相当数量的患儿会出现疾病复发。缓解期的持续时间和复发部位都是重要的预后因素。本篇综述主要聚焦于骨髓外（骨髓外部位）孤立性白血病复发。本文综述了合作研究组和大型单一机构的数据，内容涉及孤立性骨髓外复发的发生率以及复发后的结果。本文还讨论了睾丸和中枢神经系统（孤立性骨髓外复发最常见的两个部位）的独特解剖和生理特性。最后，本文还回顾了白血病治疗的发展，重点介绍了未来治疗工作的目标和挑战。
