儿童急性淋巴细胞白血病复发的研究进展

儿童急性淋巴细胞白血病(ALL)的治愈率不断提升,而复发成为ALL诊疗的瓶颈。本文从发病机理、危险分层、治疗进展三方面回顾分析了近十年关于儿童急性淋巴细胞白血病复发的文献。发现部分基因组异常和耐药性相关,成为ALL复发的主要原因之一。早期复发较晚期复发预后要差,且检测微小残留白血病对复发有独立预测作用。治疗手段从化疗和造血干细胞移植发展到分子靶向治疗、细胞治疗和免疫治疗新的层次。所以,正确认识ALL复发的发病机理、依据危险程度分层次进行综合治疗是ALL复发目前诊疗的趋势。

Research progress in relapsed childhood acute lymphoblastic leukemia

Although most children with acute lymphoblastic leukemia （ALL） are cured, certain subsets have a high risk of relapse. Treating relapsed ALL has become increasingly challenging. This paper retrospectively analyzed recent ten years studies about biological mechanisms, risk stratification and treatment with relapsed childhood ALL. There is a positive correlation between the abnormal genome and drug resistance. The prognosis of early relapsed is worse than lately relapsed. Meanwhile, minimum residual disease measurement is an independent prognostic factor for relapsed ALL. Other than traditional chemotherapy and hematopoietic stem cell transplantation, molecularly targeted therapies, cell therapies and immunotherapies have a rapid development nowadays. Thus it is a new trend that improved biological understanding of mechanisms of relapse and risk-adjusted comprehensive therapy.