儿童急性淋巴细胞白血病个体化治疗现状

急性淋巴细胞白血病（ALL）是儿童时期发病率最高的恶性肿瘤，是由于造血干细胞增殖分化异常而引起的恶性血液病。目前，儿童ALL的治疗效果明显改善，行之有效的方法主要是个体化治疗。对于标危ALL，降低了化疗强度从而减轻化疗药物的副作用，只有对真正属于高危型的ALL才进一步加强化疗，且应根据其不同的生物学特征采用不同的治疗手段。对于复发型ALL，即使加强化疗或换用新药，其预后仍旧较差，可采取分子靶向治疗或造血干细胞移植。此外，近年来微小残留病检测技术及药物基因组学研究的发展在一定程度上有助于评价化疗药物敏感性并判断预后，也为ALL个体化治疗提供了可靠的客观依据。本文就目前儿童ALL个体化治疗现状进行综述。

Present status of Individualized Therapy in Childhood Acute Lymphoblastic Leukemia-- Review

Acute lymphoblastic leukemia is the commonest pediatric malignancy caused by the disturbed differentiation of hematopoietic stem cells. Due to the effective measure of individualized therapy, the outcome of ALL therapy has been improved dramatically in recent decades. The reduction of treatment intensity in favorable patient groups decreases acute and long-term toxicity, only for the high-risk groups the intensive chemotherapy is of value, and the different therapies should be used, depending on their different biologic features. Even with intensive therapy or new drugs, the outcome of replapsed ALL remains poor, the treatment could be turned to the molecularly defined targeted drugs and stem cell transplantation. What is more, the progress in the detection technique for minimal residual disease and pharmacogenomics help to estimate the sensitivity of chemotherapy and judge the prognosis, so as to provide the reliable objective foundation for the individualized therapy. In this review, the present statas of individualized therapy in childhood acute lymphoblastic lenkemia is discussed and summarized.