Fielding Adele K
From the UCL Cancer Institute, London, United Kingdom.
Am Soc Clin Oncol Educ Book. 2015:e352-9. doi: 10.14694/EdBook_AM.2015.35.e352.
The article addresses selected key areas of flux in the management of Philadelphia chromosome-positive acute lymphoblastic leukemia. There is no doubt that tyrosine kinase inhibitors (TKIs) have made a major contribution to higher rates of complete remission and that more patients are now surviving long term. Many patients tolerate TKIs well, and remission can be achieved with minimal toxicity. Because remissions can include a proportion of patients who become BCR-ABL1 transcript negative, the question of whether allogeneic hematopoietic stem cell transplantation can be avoided requires discussion. Despite the major progress that has been made and the relative profusion of therapeutic choice compared with 10 years ago, evidence is still lacking for many of the major possible interventions, and how to combine them is unclear. Because of the rarity of the condition and the enticing possibility of increasing traction to therapy, clinical trials and international cooperation remain paramount.
本文探讨了费城染色体阳性急性淋巴细胞白血病治疗中一些关键的变化领域。毫无疑问，酪氨酸激酶抑制剂（TKIs）对提高完全缓解率做出了重大贡献，现在有更多患者能够长期存活。许多患者对TKIs耐受性良好，且能以最小的毒性实现缓解。由于缓解患者中可能包括一部分BCR-ABL1转录本转阴的患者，因此是否可以避免异基因造血干细胞移植的问题需要讨论。尽管与10年前相比已经取得了重大进展且治疗选择相对丰富，但许多主要的可能干预措施仍缺乏证据，且如何将它们联合使用尚不清楚。由于该病罕见且治疗吸引力不断增加，临床试验和国际合作仍然至关重要。
