提高儿童白血病化疗的安全性

近十年来,我国儿童急性淋巴细胞白血病的治疗缓解率和长期无病生存率均有很大提高.随着经济发展水平的提高,就诊患儿数也在增多.我们面临的新的挑战是,规范诊断和形态学、免疫学、细胞遗传学、分子生物学(MICM)分型;按照危险度分型适度治疗;开展早期治疗反应评估特别是微小残留病(MRD)检测.因此,需要成立、加强多中心协作研究,推广规范的诊断和分型标准,适当调整治疗强度,从而提高化疗的安全性,降低化疗相关死亡率及复发率,从整体上提高长期无病生存率并获得高质量的生存.

Improvement of chemotherapy safety in leukemic children

The last decade witnessed greatly improved rates of complete remission and event free survival in childhood acute lymphoblastic leukemia in China. More patients are capable of receiving treatment as the economy prospers. The new challenges now confronted us include standardization of diagnosis and morphology,immunology,cytogenetics and molecular biology(MICM)classification,appropriate treatment intensity based on the risk of patients' relapse,evaluation of response to early treatment especially minimal residual disease(MRD)detection. To improve chemotherapy safety,i.e.,reduction of both treatment-related mortality and rate of relapse simultaneously,as well as to provide patients with long term event-free and high quality survival,establishment and reinforcement of multi-center cooperative research,spreading standardized criteria of diagnosis and classification,appropriate adjustment of treatment intensification are needed to be accomplished.