文章：

急性淋巴细胞白血病：全面回顾与2017年更新

Acute lymphoblastic leukemia: a comprehensive review and 2017 update

原文发布日期：2017-06-30

DOI: 10.1038/bcj.2017.53

类型: Review

开放获取: 是

英文摘要：

Acute lymphoblastic leukemia (ALL) is the second most common acute leukemia in adults, with an incidence of over 6500 cases per year in the United States alone. The hallmark of ALL is chromosomal abnormalities and genetic alterations involved in differentiation and proliferation of lymphoid precursor cells. In adults, 75% of cases develop from precursors of the B-cell lineage, with the remainder of cases consisting of malignant T-cell precursors. Traditionally, risk stratification has been based on clinical factors such age, white blood cell count and response to chemotherapy; however, the identification of recurrent genetic alterations has helped refine individual prognosis and guide management. Despite advances in management, the backbone of therapy remains multi-agent chemotherapy with vincristine, corticosteroids and an anthracycline with allogeneic stem cell transplantation for eligible candidates. Elderly patients are often unable to tolerate such regimens and carry a particularly poor prognosis. Here, we review the major recent advances in the treatment of ALL.

摘要翻译： 

急性淋巴细胞白血病（ALL）是成人中第二常见的急性白血病，仅在美国每年发病率就超过6500例。ALL的标志是染色体异常以及涉及淋巴前体细胞分化和增殖的遗传改变。在成人中，75%的病例源自B细胞系的前体，其余病例由恶性T细胞前体构成。传统上，风险分层基于年龄、白细胞计数和对化疗的反应等临床因素；然而，复发性遗传改变的识别有助于完善个体预后并指导治疗管理。尽管治疗管理有所进展，但治疗核心仍是以长春新碱、皮质类固醇和蒽环类药物为基础的多药化疗，并对符合条件的候选者进行异基因干细胞移植。老年患者通常无法耐受此类方案，且预后尤其不良。在此，我们综述了ALL治疗的主要近期进展。

原文链接：

Acute lymphoblastic leukemia: a comprehensive review and 2017 update