Section of Pediatric Hematology/Oncology/Stem Cell Transplant, Department of Pediatrics, University of Chicago, Chicago, Illinois.
Department of Radiation Medicine, Oregon Health & Science University, Bend, Oregon.
Pediatr Blood Cancer. 2018 Jun;65(6):e26989. doi: 10.1002/pbc.26989. Epub 2018 Feb 8.
Compared to younger and older age groups, the incidence of acute lymphoblastic leukemia (ALL) and lymphoblastic lymphoma (LBL) has increased more in the adolescent and young adult (AYA) population, the cause of which is unknown. As of the last decade, only half of the AYA patients with these diseases were surviving 10 years. Strong evidence exists that favors "pediatric" treatment regimens for AYAs compared to "adult" treatment regimens in terms of survival rates, hospitalization time, toxicities, late effects, and quality of life both during and after treatment. Targeted agents are clinically accessible for certain subsets of patients with Philadelphia-like ALL, the incidence of which peaks in AYAs. Treatment teams must appreciate the complex psychosocial underpinnings in these patients in order to maximize compliance with the prolonged and complex treatment plans during the AYA years.
与年轻和老年群体相比，青少年和年轻成人（AYA）群体中急性淋巴细胞白血病（ALL）和淋巴母细胞淋巴瘤（LBL）的发病率上升更多，但其病因尚不清楚。在过去十年中，只有一半患有这些疾病的 AYA 患者能存活 10 年。有强有力的证据表明，在生存率、住院时间、毒性、晚期效应和治疗期间及之后的生活质量方面，与“成人”治疗方案相比，AYA 患者更适合采用“儿科”治疗方案。对于费城样 ALL 的某些亚组患者，靶向药物在临床上是可用的，而其发病率在 AYA 中达到高峰。治疗团队必须了解这些患者复杂的心理社会基础，以便在 AYA 期间最大限度地遵守延长和复杂的治疗计划。
