Bone Marrow Transplantation Center, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.
Liangzhu Laboratory, Zhejiang University Medical Center, Hangzhou 311121, China.
J Zhejiang Univ Sci B. 2022 Oct 15;23(10):876-880. doi: 10.1631/jzus.B2200128.
Despite the advancement of treatments, adults with relapsed/refractory (R/R) B-lineage acute lymphoblastic leukemia (B-ALL) have poor prognosis, with an expected five-year overall survival (OS) rate of 10%‒20% (Nguyen et al., 2008; Oriol et al., 2010). Extramedullary relapse of B-ALL is regarded as a high-risk factor generally associated with poor survival, occurring in about 15% to 20% of all relapsed patients (Ding et al., 2017; Sun et al., 2018). The central nervous system (CNS) and the testes are the most common sites of extramedullary relapse of B-ALL. In addition, extramedullary leukemia can appear in the skin, eyes, breasts, bones, muscles, and abdominal organs. The prognosis of relapsed extramedullary B-ALL after allogeneic hematopoietic stem cell transplantation (allo-HSCT) is extremely poor (Spyridonidis et al., 2012; Dahlberg et al., 2019). Conventional chemotherapy or radiation is often ineffective in such patients. At present, there are no optimal treatment strategies for treating extramedullary leukemia after allo-HSCT.
尽管治疗方法有所进步，但复发/难治性（R/R）B 细胞急性淋巴细胞白血病（B-ALL）成人患者预后较差，预期五年总生存率（OS）为 10%-20%（Nguyen 等人，2008 年；Oriol 等人，2010 年）。B-ALL 的髓外复发通常被认为是与生存不良相关的高危因素，约占所有复发患者的 15%-20%（Ding 等人，2017 年；Sun 等人，2018 年）。中枢神经系统（CNS）和睾丸是 B-ALL 髓外复发最常见的部位。此外，髓外白血病可出现在皮肤、眼睛、乳房、骨骼、肌肉和腹部器官。异基因造血干细胞移植（allo-HSCT）后复发的髓外 B-ALL 预后极差（Spyridonidis 等人，2012 年；Dahlberg 等人，2019 年）。此类患者常规化疗或放疗通常无效。目前，allo-HSCT 后治疗髓外白血病尚无最佳治疗策略。
