Rytting Michael E, Jabbour Elias J, O'Brien Susan M, Kantarjian Hagop M
Department of Pediatrics-Patient Care, Children's Cancer Hospital, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Cancer. 2017 Jul 1;123(13):2398-2403. doi: 10.1002/cncr.30624. Epub 2017 Mar 22.
Acute lymphoblastic leukemia (ALL) in the adolescent and young adult (AYA) population is a difficult clinical problem. The AYA population, generally regarded as patients aged 15 to 39 years, currently draws a good deal of attention, particularly in the area of therapy selection. The current trend is to treat this group of patients with leukemia regimens based on pediatric protocols, and results comparing pediatric approaches versus adult approaches to treatment are maturing. Results are pending from a large US trial in which pediatric-based treatment is given to AYA patients with ALL. In tandem with these new clinical trials, researchers have reported disease features in the AYA group that may explain some of the differences in response to treatment observed in the AYA population compared with the pediatric population. In addition, unique social factors in this age group add to the complexity of ALL therapy in the AYA population. AYA patients are developing independence and separating from their parents. They tend to be noncompliant. Young adults suffer from a lack of health care insurance and poor access to clinical trials, and have specific concerns regarding toxicities, in particular fertility. Cancer 2017;123:2398-403. © 2017 American Cancer Society.
青少年及年轻成人（AYA）群体中的急性淋巴细胞白血病（ALL）是一个棘手的临床问题。AYA群体一般指年龄在15至39岁的患者，目前备受关注，尤其是在治疗方案选择方面。当前的趋势是采用基于儿科方案的白血病治疗方案来治疗这组患者，比较儿科治疗方法与成人治疗方法的结果正在逐渐成熟。美国一项大型试验的结果尚未得出，该试验将基于儿科的治疗方法应用于患有ALL的AYA患者。与这些新的临床试验同时进行的是，研究人员报告了AYA群体的疾病特征，这些特征可能解释了与儿科群体相比，AYA群体在治疗反应上观察到的一些差异。此外，这个年龄组独特的社会因素增加了AYA群体ALL治疗的复杂性。AYA患者正在走向独立并与父母分离。他们往往不依从治疗。年轻成人缺乏医疗保险且难以参与临床试验，并且对毒性，尤其是生育能力，有特定的担忧。《癌症》2017年；123：2398 - 403。© 2017美国癌症协会。
