Pui C H, Crist W M
St. Jude Children's Research Hospital, Memphis, Tennessee.
Curr Opin Oncol. 1995 Jan;7(1):36-44.
Contemporary protocols, featuring early intensive multiagent chemotherapy, will cure at least 65% of children with acute lymphoblastic leukemia and up to 40% of those with acute myeloid leukemia. In acute lymphoblastic leukemia, emphasis is placed on stringent risk assessment at diagnosis so that only those patients at high risk of relapse are treated aggressively, with less toxic treatments reserved for lower-risk patients. Treatment strategies are less risk-based in acute myeloid leukemia, although genetic analysis has begun to aid in establishing therapeutic options for individual patients (eg, high-dose chemotherapy, differentiation-inducing agents, and bone marrow transplantation). For children with either the adult or juvenile form of chronic myeloid leukemia, allogeneic bone marrow transplantation remains the only curative treatment. In the future, it may be possible to direct therapy to specific genetic lesions that have been recently identified in leukemic cells.
当代方案以早期强化多药化疗为特色，将治愈至少65%的急性淋巴细胞白血病患儿以及高达40%的急性髓系白血病患儿。在急性淋巴细胞白血病中，重点在于诊断时进行严格的风险评估，以便仅对复发风险高的患者进行积极治疗，为低风险患者保留毒性较小的治疗方法。急性髓系白血病的治疗策略较少基于风险，尽管基因分析已开始有助于为个体患者确定治疗选择（例如，大剂量化疗、分化诱导剂和骨髓移植）。对于患有成人或青少年形式慢性髓系白血病的儿童，异基因骨髓移植仍然是唯一的治愈性治疗方法。未来，有可能针对白血病细胞中最近发现的特定基因损伤进行治疗。
