Boissel Nicolas, Ducassou Stéphane
Hôpital Saint-Louis, unité d'hématologie adolescents et jeunes adultes, 1, avenue Claude-Vellefaux, 75010 Paris, France.
Hôpital des enfants, unité d'hématologie et oncologie pédiatrique, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France.
Bull Cancer. 2017 Jul-Aug;104(7-8):683-689. doi: 10.1016/j.bulcan.2017.03.002. Epub 2017 May 31.
The acute lymphoblastic leukemia (ALL) is one of the first cancer for which emerged the particularity of the adolescent and young adult population. After decades of poorly concerted approaches, adult and pediatric haematologists found out that adolescents treated according to pediatric approaches had a better outcome than those treated in adult protocols. Therefore, pediatric-inspired therapies have been successfully implemented in the young adult population, leading to decreased criteria for allogeneic stem cell transplantation. More recently, a high prevalence of Philadelphia-like ALL has been identified in the AYA population, which opens the door to the combination of target therapy similar to Philadelphia-positive ALL. AYA patients require specific care programs including fertility counselling, adhesion evaluation, and long-term survivor follow-up. They are to be optimally treated by multidisciplinary teams, exploring their personal needs and determining the best management of the "whole patient".
急性淋巴细胞白血病（ALL）是最早出现青少年和青年人群特殊性的癌症之一。经过数十年协调不佳的治疗方法后，成人和儿科血液学家发现，按照儿科治疗方法治疗的青少年比按照成人方案治疗的青少年预后更好。因此，受儿科启发的疗法已在青年人群中成功实施，从而降低了异基因干细胞移植的标准。最近，在青少年和青年人群中发现了费城样ALL的高患病率，这为类似于费城阳性ALL的靶向治疗联合应用打开了大门。青少年和青年患者需要特定的护理计划，包括生育咨询、依从性评估和长期幸存者随访。他们应由多学科团队进行最佳治疗，探索他们的个人需求并确定对“全人”的最佳管理。
