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成人中枢神经系统白血病的诊断与管理

Diagnosis and management of adult central nervous system leukemia.

作者信息

Liu Siyu, Wang Ying

机构信息

State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China.

出版信息

Blood Sci. 2023 May 30;5(3):141-149. doi: 10.1097/BS9.0000000000000162. eCollection 2023 Jul.

Abstract

Central nervous system leukemia (CNSL) is a prominent infiltration reason for therapy failing in acute leukemia. Recurrence rates and the prognosis have alleviated with current prophylactic regimens. However, the accurate stratification of relapse risk and treatment regimens for relapsed or refractory patients remain clinical challenges yet to be solved. Recently, with hematopoietic stem cell transplantation (HSCT) and chimeric antigen receptor-T (CAR-T) cellular therapy showing encouraging effects in some CNSL patients, advances in treating CNSL have already been reported. The development of molecular targeted agents as well as antibody-based drugs will provide patients with more personalized treatment. This article summarized recent research developments about risk factors, diagnosis, prevention, and treatment in adults with CNSL.

摘要

中枢神经系统白血病(CNSL)是急性白血病治疗失败的一个突出浸润原因。当前的预防性方案已使复发率和预后有所改善。然而,对于复发或难治性患者,准确分层复发风险以及确定治疗方案仍是有待解决的临床挑战。最近,随着造血干细胞移植(HSCT)和嵌合抗原受体T细胞(CAR-T)细胞疗法在一些CNSL患者中显示出令人鼓舞的效果,已有关于CNSL治疗进展的报道。分子靶向药物以及基于抗体的药物的发展将为患者提供更个性化的治疗。本文总结了成人CNSL在危险因素、诊断、预防和治疗方面的最新研究进展。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/84b0/10400053/caa3f7179f22/bs9-5-141-g001.jpg

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