Leukemia Program, Continuum Cancer Centers of New York, St. Luke's - Roosevelt Hospital Center, NY 10019, USA.
Curr Treat Options Oncol. 2011 Dec;12(4):303-11. doi: 10.1007/s11864-011-0167-z.
Much new information about ALL in adults has recently been learned from major clinical and laboratory studies. However, much of the recently reported improved management of this leukemia pertains only to younger patients. Elderly patients do not fair very well with modern therapy, including intensified treatment approaches. The question arises whether current treatment may be unnecessarily intensive, not only for elderly patients but for most patients. There are no prospective, randomized studies that clearly demonstrate that anthracyclines, cyclophosphamide or cytarabine are required for optimal results in this leukemia. Eliminating drugs of marginal value but with the potential for considerable toxicity may allow us to intensify treatment with drugs that are most effective at a cost of even less toxicity than usually expected.
最近，从重大的临床和实验室研究中获得了大量有关成人 ALL 的新信息。然而，最近报告的许多对这种白血病的改进管理仅适用于年轻患者。老年患者的现代疗法效果不佳，包括强化治疗方法。目前的治疗方法是否不必要地过于强烈，不仅对老年患者，而且对大多数患者都是如此，这就出现了一个问题。没有前瞻性、随机的研究清楚地表明，蒽环类药物、环磷酰胺或阿糖胞苷是这种白血病获得最佳效果所必需的。消除具有潜在毒性的药物，但具有潜在毒性的药物可能使我们能够用最有效的药物来强化治疗，其毒性比通常预期的还要小。
