Jabbour Elias J, Kantarjian Hagop M, Goekbuget Nicola, Shah Bijal D, Chiaretti Sabina, Park Jae H, Rijneveld Anita W, Gore Lia, Fleming Shaun, Logan Aaron C, Ribera Josep M, Menne Tobias F, Mezzi Khalid, Zaman Faraz, Velasco Kelly, Boissel Nicolas
Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Department of Medicine II, Goethe University, University Hospital, Frankfurt, Germany.
Blood Cancer J. 2024 Nov 19;14(1):203. doi: 10.1038/s41408-024-01179-4.
This narrative review seeks to summarize chemotherapeutic regimens commonly used for patients with newly diagnosed Philadelphia (Ph) chromosome-negative B-cell precursor acute lymphoblastic leukemia (BCP-ALL) in the frontline setting and to describe the latest clinical research using the bispecific T-cell-engaging immunotherapy blinatumomab in the first-line treatment setting. Current standard-of-care chemotherapeutic backbones for newly diagnosed Ph-negative BCP-ALL are based on the same overarching treatment principle: to reduce disease burden to undetectable levels and maintain lasting remission. The adult treatment landscape has progressively evolved following the adoption of pediatric-inspired regimens. However, these intense regimens are not tolerated by all, and high-risk patients still have inferior outcomes. Therefore, designing more effective and less toxic strategies remains key to further improving efficacy and safety outcomes. Overall, the treatment landscape is evolving in the frontline, and integration of blinatumomab into different standard frontline regimens may improve overall outcomes with a favorable safety profile.
本叙述性综述旨在总结一线治疗中初诊费城（Ph）染色体阴性B细胞前体急性淋巴细胞白血病（BCP-ALL）患者常用的化疗方案，并描述在一线治疗中使用双特异性T细胞衔接免疫疗法博纳吐单抗的最新临床研究。初诊Ph阴性BCP-ALL的当前标准护理化疗主干基于相同的总体治疗原则：将疾病负担降低到检测不到的水平并维持持久缓解。采用受儿科启发的方案后，成人治疗格局逐渐演变。然而，并非所有患者都能耐受这些强化方案，高危患者的预后仍然较差。因此，设计更有效且毒性更小的策略仍然是进一步提高疗效和安全性结果的关键。总体而言，一线治疗格局正在演变，将博纳吐单抗纳入不同的标准一线方案可能会改善总体结果，并具有良好的安全性。
