University of Virginia Health System, Charlottesville, VA, USA.
University of Virginia Hospital, 6011 West Complex, Charlottesville, VA, 22908-0716, USA.
Curr Hematol Malig Rep. 2018 Apr;13(2):100-108. doi: 10.1007/s11899-018-0442-1.
Adolescent and Young Adult (AYA) Oncology is a relatively new field encompassing research in the unique pathophysiology, clinical care, and psychosocial issues facing patients between the ages of 15 and 40 with cancer. About 100,000 of the approximately 1.5 million people diagnosed annually with cancer in the USA are in this age range. This chapter will review notable new developments in the care of adolescents and young adults with acute lymphoblastic leukemia (ALL) within the last 3 years.
The preponderance of data favors the treatment of AYA ALL patients with pediatric-inspired treatment regimens due to better relapse-free and overall survival. Minimal residual disease (MRD) measurement is emerging as an important prognostic factor and can serve as a new measure of efficacy of the addition of novel therapies to the treatment of patients with new diagnoses. There have been several treatment advances ranging from new cytotoxic agents for ALL to new antibody-based therapy to novel immune therapies such as CAR-T cells. The care of AYA ALL patients is improving as the unique issues for this patient population are addressed.
青少年和青年成人肿瘤学是一个相对较新的领域，涵盖了对年龄在 15 至 40 岁之间患有癌症的患者独特的病理生理学、临床护理和社会心理问题的研究。在美国，每年约有 150 万人被诊断出患有癌症，其中约有 10 万人处于这个年龄段。这一章将回顾过去 3 年中在急性淋巴细胞白血病（ALL）青少年和青年成人治疗方面的显著新进展。
大量数据支持对青少年和青年成人 ALL 患者采用儿科启发的治疗方案进行治疗，因为这可以提高无病生存率和总生存率。微小残留病（MRD）测量正在成为一个重要的预后因素，并可以作为评估新诊断患者新型治疗方法疗效的新指标。已经有了许多治疗进展，包括用于 ALL 的新型细胞毒性药物、新型抗体治疗方法以及新型免疫治疗方法，如 CAR-T 细胞。随着针对这一患者群体独特问题的解决，青少年和青年成人 ALL 患者的治疗正在得到改善。
