Wang Jian, Chen Chun
Department of Pediatrics, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, Guangdong Province, China.
Department of Pediatrics, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, Guangdong Province, China. E-mail:
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2013 Dec;21(6):1617-22. doi: 10.7534/j.issn.1009-2137.2013.06.047.
Acute lymphoblastic leukemia is the commonest pediatric malignancy caused by the disturbed differentiation of hematopoietic stem cells. Due to the effective measure of individualized therapy, the outcome of ALL therapy has been improved dramatically in recent decades. The reduction of treatment intensity in favorable patient groups decreases acute and long-term toxicity, only for the high-risk groups the intensive chemotherapy is of value, and the different therapies should be used, depending on their different biologic features.Even with intensive therapy or new drugs, the outcome of relapsed ALL remains poor, the treatment could be turned to the molecularly defined targeted drugs and stem cell transplantation. What is more, the progress in the detection technique for minimal residual disease and pharmacogenomics help to estimate the sensitivity of chemotherapy and judge the prognosis, so as to provide the reliable objective foundation for the individualized therapy.In this review, the present states of individualized therapy in childhood acute lymphoblastic leukemia is discussed and summarized.
急性淋巴细胞白血病是造血干细胞分化紊乱导致的最常见儿童恶性肿瘤。由于个体化治疗的有效措施,近几十年来急性淋巴细胞白血病的治疗效果有了显著改善。在预后良好的患者群体中降低治疗强度可减少急性和长期毒性,仅对高危群体而言强化化疗才有价值,应根据其不同的生物学特征采用不同的治疗方法。即使采用强化治疗或新药,复发急性淋巴细胞白血病的治疗效果仍然很差,治疗可转向分子靶向药物和干细胞移植。此外,微小残留病检测技术和药物基因组学的进展有助于评估化疗敏感性和判断预后,从而为个体化治疗提供可靠的客观依据。在本综述中,对儿童急性淋巴细胞白血病个体化治疗的现状进行了讨论和总结。