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费城染色体阳性急性淋巴细胞白血病治疗进展
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Abstract:
费城染色体阳性急性淋巴细胞白血病(Ph+ ALL)在成人中较常见，发病率随年龄增长而增加，恶性度较高，传统的化疗效果不佳，造血干细胞移植是治愈该疾病的手段，在首次缓解期(CR1)行异基因造血干细胞移植能提高患者的预后，但也面临着复发、供者来源和受者自身情况的限制。随着酪氨酸激酶抑制剂(TKIs)在临床上的应用提高了患者的缓解率，使更多的人获得移植的机会，成为Ph+ ALL治疗策略的基石，但是由于TKIs的耐药性导致复发等问题，进一步研发的新型的TKIs和单克隆抗体的应用减少了对化疗的依赖，挑战了异基因造血干细胞移植的地位，但目前认为异基因造血干细胞移植仍是治疗Ph+ ALL最具潜力的方法。本综述介绍了Ph+ ALL的治疗进展。
Philadelphia chromosome positive acute lymphoblastic leukemia (Ph+ ALL) is more common in adults. The incidence rate increases with age, and the malignancy is high. The traditional chemo-therapy is not effective. Hematopoietic stem cell transplantation is the means to cure the disease. Allogeneic hematopoietic stem cell transplantation in the first remission period (CR1) can improve the prognosis of patients, but also faces the limitations of recurrence, donor source and recipient’s own conditions. With the clinical application of tyrosine kinase inhibitors (TKIs), the remission rate of patients has been improved, and more people have been given the chance of transplantation, which has become the cornerstone of Ph+ ALL treatment strategy. However, the drug resistance of TKIs leads to recurrence and other problems. The application of further developed new TKIs and monoclonal antibodies reduces the dependence on chemotherapy and challenges the status of al-logeneic hematopoietic stem cell transplantation. However, at present, allogeneic hematopoietic stem cell transplantation is still the most promising method for the treatment of Ph+ ALL. This re-view introduces the treatment progress of Ph+ ALL.
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