成人急性淋巴细胞白血病的治疗现状及展望

近年来随着科学的发展,成人急性淋巴细胞白血病的治疗有了很大的进展。诱导治疗至少应用一次糖皮质激素+长春新碱+蒽环类药,尽量加用门冬酰胺酶,强烈的诱导治疗必须权衡利弊。在强烈的诱导和巩固后维持治疗仍然是急性淋巴细胞白血病患者的标准治疗。高危患者在第一次完全缓解时推荐干细胞移植,标危者不推荐。中枢神经系统白血病的预防性治疗是防止中枢神经系统受累或复发的基础。总之,成人急淋应根据预后因素及患者特点等确定个体化治疗。

Current Condition and Prospects of Treatment of Adult ALL

In recent years,the development in the treatment of adult ALL has been evident.Induction therapy includes at least one-dose glucocorticoid,vincristine,anthracycline and probably asparaginase.Intensive induction therapy must balance the gains and losses.Intensive consolidation therapy is still standard.Maintenance therapy is still standard even after the intensive induction and consolidation therapy,leading to inferior long-term outcomes.SCTin CR1 is recommended in high-risk patients but not in standard-risk ALL patients.Prophylaxis of CNSL is required to prevent the involvement and relapse of CNS.The treatment of adult ALL should be individualized based on the prognostic factors and patient characteristics.