Departments of Global Pediatric Medicine and Oncology, St. Jude Children's Research Hospital, Memphis, TN, 38103, USA.
Indian J Pediatr. 2024 Feb;91(2):168-175. doi: 10.1007/s12098-023-04745-z. Epub 2023 Aug 29.
Acute lymphoblastic leukemia (ALL) is the most common malignancy in children. The T-cell subtype (T-ALL) accounts for 10-15% of pediatric ALL cases and has been historically associated with outcomes inferior to those of B-cell ALL (B-ALL). The prognosis of T-ALL has significantly improved with contemporary intensive pediatric regimens. However, most children with relapsed T-ALL have dismal outcomes and fewer therapeutic salvage options than those available for B-ALL. After demonstrating efficacy in relapsed T-ALL, nelarabine is being increasingly incorporated into frontline T-ALL regimens. The development of genomic sequencing has led to the identification of new T-ALL subgroups and potential targeted therapeutic approaches which could improve patients' outcomes and reduce the toxicity associated with current therapy. Immunotherapy and cellular therapy regimens are also under early investigation in T-cell malignancies. This review outlines the clinical and biological characteristics of T-ALL and provides an overview of novel treatment options for refractory and relapsed T-ALL.
急性淋巴细胞白血病（ALL）是儿童中最常见的恶性肿瘤。T 细胞亚型（T-ALL）占儿童 ALL 病例的 10-15%，历史上与 B 细胞 ALL（B-ALL）相比，其预后较差。随着当代强化儿科方案的应用，T-ALL 的预后有了显著改善。然而，大多数复发的 T-ALL 患儿预后不良，可供选择的治疗方案比 B-ALL 少。在复发的 T-ALL 中显示出疗效后，那拉滨正越来越多地被纳入 T-ALL 的一线治疗方案中。基因组测序的发展导致了新的 T-ALL 亚组的发现和潜在的靶向治疗方法，这些方法可能改善患者的预后，并降低与当前治疗相关的毒性。免疫治疗和细胞治疗方案也正在 T 细胞恶性肿瘤的早期研究中。本文概述了 T-ALL 的临床和生物学特征，并对难治性和复发性 T-ALL 的新治疗选择进行了综述。
