Childhood acute lymphoblastic leukemia (ALL) has witnessed substantial improvements in prognosis; however, a subset of patients classified as high-risk continues to face higher rates of relapse and increased mortality. While the National Cancer Institute (NCI) criteria have traditionally guided risk stratification based on initial clinical information, recent advances highlight the pivotal role of biological markers in shaping the prognosis of childhood ALL. This review delves into the emerging understanding of high-risk childhood ALL, focusing on molecular, cytogenetic, and immunophenotypic markers. These markers not only contribute to unraveling the underlying mechanisms of the disease, but also shed light on specific clinical patterns that dictate prognosis. The paradigm shift in treatment strategies, exemplified by the success of tyrosine kinase inhibitors in Philadelphia chromosome-positive leukemia, underscores the importance of recognizing and targeting precise risk factors. Through a comprehensive exploration of high-risk childhood ALL characteristics, this review aims to enhance our comprehension of the disease, offering insights into its molecular landscape and clinical intricacies in the hope of contributing to future targeted and tailored therapies.
儿童急性淋巴细胞白血病（ALL）的预后已取得显著改善，但部分被归类为高危的患者仍面临较高的复发率和死亡率。尽管美国国家癌症研究所（NCI）标准传统上基于初始临床信息指导风险分层，但近期研究进展突显了生物学标志物在儿童ALL预后评估中的关键作用。本综述深入探讨了高危儿童ALL的新认知，重点关注分子、细胞遗传学和免疫表型标志物。这些标志物不仅有助于揭示疾病的潜在机制，还揭示了决定预后的特定临床模式。治疗策略的范式转变——以酪氨酸激酶抑制剂在费城染色体阳性白血病中的成功为例——强调了识别并精准靶向风险因素的重要性。通过对高危儿童ALL特征的全面探讨，本综述旨在深化对该疾病的理解，揭示其分子特征和临床复杂性，以期对未来靶向性和个体化治疗的发展提供参考。
Biological Markers of High-Risk Childhood Acute Lymphoblastic Leukemia
肿瘤(癌症)患者之家