Cleveland Clinic Taussig Cancer Institute, Cleveland, OH, USA.
Cleveland Clinic Pediatric Hematology-Oncology, Cleveland, OH, USA.
Leuk Lymphoma. 2020 Jan;61(1):18-26. doi: 10.1080/10428194.2019.1658103. Epub 2019 Aug 27.
Adolescents and young adults (AYAs) with ALL represent a unique population in terms of their biology and treatment. Studies have demonstrated an improved outcome when these patients are treated with pediatric-inspired regimens. Novel antibody based therapies have demonstrated impressive results in relapsed/refractory B-ALL and are starting to be evaluated in the upfront setting. Immunotherapy with CAR T cells had great success in ALL and clinical trials are ongoing and further studies are being done to expand access to this therapy and decrease toxicities. Although our outcomes with this disease have improved significantly, transplant still plays a role for high risk patients in CR1 (based on MRD status) and for patients with relapsed/refractory ALL.
青少年和年轻成人（AYAs）的急性淋巴细胞白血病（ALL）在生物学和治疗方面具有独特性。研究表明，采用儿童启发式方案治疗这些患者可改善预后。新型基于抗体的疗法在复发/难治性 B-ALL 中显示出令人印象深刻的结果，并且正在进行前期评估。嵌合抗原受体 T 细胞免疫疗法在 ALL 中取得了巨大成功，临床试验正在进行中，进一步的研究正在进行，以扩大这种疗法的应用，并降低毒性。尽管我们对这种疾病的治疗效果有了显著改善，但对于缓解期 1（基于微小残留病灶状态）的高危患者和复发/难治性 ALL 患者，移植仍然具有重要作用。
