Ribera Josep-Maria, Genescà Eulàlia, Ribera Jordi
Clinical Hematology Department, ICO-Hospital Germans Trias I Pujol, Badalona, Spain; Josep Carreras Leukemia Research Institute, 08916 Badalona, Spain; Universitat Autònoma de Barcelona, Spain.
Josep Carreras Leukemia Research Institute, 08916 Badalona, Spain.
Clin Lymphoma Myeloma Leuk. 2020 Sep;20 Suppl 1:S48-S51. doi: 10.1016/S2152-2650(20)30459-6.
The decision to incorporate allogeneic hematopoietic stem cell transplant (allo-HSCT) into front-line therapy in adult acute lymphoblastic leukemia (ALL) should be primarily guided by measurable residual disease (MRD) status and the ALL regimen utilized. While there is no doubt that allo-HSCT benefits patients with poor MRD response after induction or consolidation, the indication of allo-HSCT in cases of good MRD clearance is not clear. As targeted immunotherapies result in high MRD-negative CR rates, early incorporation of these therapies may also prove valuable in reducing the need for HCT in the front-line setting. This review discusses the data and controversies related to allo-HSCT in the front-line therapy of Philadelphia chromosome-negative and -positive ALL.
将异基因造血干细胞移植（allo-HSCT）纳入成人急性淋巴细胞白血病（ALL）一线治疗的决策，应主要依据可测量残留病（MRD）状态以及所采用的ALL治疗方案。虽然毫无疑问，allo-HSCT对诱导或巩固治疗后MRD反应不佳的患者有益，但在MRD清除良好的情况下allo-HSCT的适应证尚不清楚。由于靶向免疫疗法可带来较高的MRD阴性完全缓解率，早期纳入这些疗法在减少一线治疗中对造血干细胞移植（HCT）的需求方面可能也具有价值。本综述讨论了与费城染色体阴性和阳性ALL一线治疗中allo-HSCT相关的数据和争议。
