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[成人急性淋巴细胞白血病:病理生理学与治疗的最新进展]

[Adult acute lymphoblastic leukemia: update on pathophysiology and management].

作者信息

Hayakawa Fumihiko

机构信息

Department Pathophysiological Laboratory Sciences, Nagoya University Graduate School of Medicine.

出版信息

Rinsho Ketsueki. 2018;59(5):497-503. doi: 10.11406/rinketsu.59.497.

Abstract

For a long time, treatment for adult acute lymphoblastic leukemia (ALL) lacked significant improvements. Since 2000, new approaches, such as the treatments of adolescent and young adult ALL using pediatric-like protocols and Ph+ ALL treatments using tyrosine kinase inhibitor-combined chemotherapies. Further improvements are expected from the use of pediatric-like protocols to whole adults, and the use of newly approved anti-cancer drugs, such as inotuzumab ozogamicin and blinatumomab. Furthermore, comprehensive genetic analyses using next generation sequencing technology have recently discovered new recurrent fusion genes of ALL, such as DUX4 fusion genes, ZNF384 fusion genes, and MEF2D fusion genes. In this review, I will introduce these frontline studies and discuss about the treatment of patients with adult ALL.

摘要

长期以来,成人急性淋巴细胞白血病(ALL)的治疗一直缺乏显著进展。自2000年以来,出现了新的治疗方法,比如采用类似儿科方案治疗青少年及青年成人ALL,以及使用酪氨酸激酶抑制剂联合化疗治疗Ph+ ALL。预计将类似儿科方案应用于所有成年人,以及使用新获批的抗癌药物,如奥英妥珠单抗和博纳吐单抗,会带来进一步改善。此外,最近利用下一代测序技术进行的全面基因分析发现了ALL新的复发性融合基因,如DUX4融合基因、ZNF384融合基因和MEF2D融合基因。在这篇综述中,我将介绍这些前沿研究,并探讨成人ALL患者的治疗。

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