Zeckanovic Aida, Fuchs Philipp, Heesen Philip, Bodmer Nicole, Otth Maria, Scheinemann Katrin
Department of Oncology, University Children's Hospital Zurich, 8032 Zurich, Switzerland.
Children's Research Center, University Children's Hospital Zurich, 8032 Zurich, Switzerland.
Curr Oncol. 2023 Sep 20;30(9):8612-8632. doi: 10.3390/curroncol30090625.
Adolescents and young adults (AYA) with acute lymphoblastic leukemia (ALL) have significantly worse outcomes than their younger counterparts. Current treatment guidelines rely mostly on non-randomized retrospective studies. We performed a systematic review of studies published within the last 15 years comparing pediatric-inspired regimens (PIR) versus adult-type regimens or performing an age-stratified analysis of outcomes in the AYA population. Due to the heterogeneity of data, a meta-analysis was not possible. However, the gathered data show a trend toward improvement in outcomes and an acceptable toxicity profile in patients treated with PIRs compared to conventional adult-type regimens. There is still room for further improvement, as older patients within the AYA population tend to perform poorly with PIR or conventional adult-type chemotherapy. Further randomized studies are needed to develop an optimal treatment strategy for AYA with ALL.
患有急性淋巴细胞白血病（ALL）的青少年和青年（AYA）的治疗结果明显比年龄较小的患者更差。当前的治疗指南主要依赖于非随机的回顾性研究。我们对过去15年内发表的研究进行了系统综述，这些研究比较了儿科启发方案（PIR）与成人型方案，或对AYA人群的治疗结果进行了年龄分层分析。由于数据的异质性，无法进行荟萃分析。然而，收集到的数据显示，与传统成人型方案相比，接受PIR治疗的患者在治疗结果方面有改善趋势，且毒性特征可接受。仍有进一步改进的空间，因为AYA人群中的老年患者采用PIR或传统成人型化疗的效果往往较差。需要进一步开展随机研究，以制定针对AYA-ALL患者的最佳治疗策略。
