Ceppi Francesco, Cazzaniga Giovanni, Colombini Antonella, Biondi Andrea, Conter Valentino
Division of Haematology/Oncology, The Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada.
Expert Rev Hematol. 2015 Feb;8(1):57-70. doi: 10.1586/17474086.2015.978281. Epub 2014 Nov 4.
With current treatment regimens, survival rates for acute lymphoblastic leukemia (ALL) have improved dramatically since the 1980s, with current 5-year overall survival rates estimated at greater than 85%. This success was achieved, in part, through the implementation of risk-stratified therapy. Nevertheless, for a subgroup of patients (15-20%) with newly diagnosed ALL who will ultimately relapse, traditional risk assessment remains inadequate. The risk of relapse may be estimated on the basis of diagnostic features or early treatment response findings. Further progress in this field may thus come from refinement of predictive factors for relapse and treatment adaptation and from the identification of biological subsets of ALL patients who could benefit from specific target therapies. This article summarizes the aspects associated with the identification of predictive factors for relapse in childhood ALL and options available for prevention of disease recurrence.
自20世纪80年代以来，采用当前的治疗方案，急性淋巴细胞白血病（ALL）的生存率有了显著提高，目前估计5年总生存率超过85%。这一成功部分得益于风险分层治疗的实施。然而，对于一部分最终会复发的新诊断ALL患者（15%-20%）来说，传统的风险评估仍然不足。复发风险可根据诊断特征或早期治疗反应结果来估计。因此，该领域的进一步进展可能来自于完善复发预测因素和治疗适应性，以及识别可从特定靶向治疗中获益的ALL患者生物学亚群。本文总结了与儿童ALL复发预测因素识别相关的方面以及预防疾病复发的可用选择。
