CNRS, IGDR (Institut de Génétique et Développement de Rennes), Univ Rennes, UMR 6290, Rennes F-35000, France; Pediatric Hematology and Oncology Department, University Hospital, Caen, France.
CNRS, IGDR (Institut de Génétique et Développement de Rennes), Univ Rennes, UMR 6290, Rennes F-35000, France.
Blood Rev. 2019 Jul;36:40-56. doi: 10.1016/j.blre.2019.04.003. Epub 2019 Apr 17.
Long-term survival rates in childhood acute lymphoblastic leukemia (ALL) are currently above 85% due to huge improvements in treatment. However, 15-20% of children still experience relapses. Relapses can either occur in the bone marrow or at extramedullary sites, such as gonads or the central nervous system (CNS), formerly referred to as ALL-blast sanctuaries. The reason why ALL cells migrate to and stay in these sites is still unclear. In this review, we have attempted to assemble the evidence concerning the microenvironmental factors that could explain why ALL cells reside in such sites. We present criteria that make extramedullary leukemia niches and solid tumor metastatic niches comparable. Indeed, considering extramedullary leukemias as metastases could be a useful approach for proposing more effective treatments. In this context, we conclude with several examples of potential niche-based therapies which could be successfully added to current treatments of ALL.
由于治疗方面的巨大进步，目前儿童急性淋巴细胞白血病（ALL）的长期生存率超过 85%。然而，仍有 15-20%的儿童会复发。复发可以发生在骨髓或骨髓外部位，如性腺或中枢神经系统（CNS），以前称为 ALL-原始庇护所。ALL 细胞迁移到这些部位并驻留的原因尚不清楚。在这篇综述中，我们试图收集有关微环境因素的证据，这些因素可以解释为什么 ALL 细胞存在于这些部位。我们提出了使骨髓外白血病龛和实体瘤转移龛具有可比性的标准。事实上，将骨髓外白血病视为转移瘤可能是提出更有效治疗方法的有用方法。在这种情况下，我们以几种基于龛的潜在治疗方法为例，这些方法可以成功地添加到目前 ALL 的治疗中。
