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优化年轻和老年成人急性淋巴细胞白血病的治疗:新药和不断发展的范式

英文原题:Optimizing the treatment of acute lymphoblastic leukemia in younger and older adults: new drugs and evolving paradigms.

PubMed 2021/06/25(内容时间) Leukemia Q1 · IF 8.8(JCR 2025)

研究概要

在过去十年中,急性淋巴细胞白血病(ALL)患者的可用治疗方法迅速扩展,与此同时,人们对影响疾病生物学和临床结局的基因组特征的理解也不断加深。

中文摘要

在过去十年中,急性淋巴细胞白血病(ALL)患者的可用治疗手段迅速扩展,与此同时,人们对影响疾病生物学和临床结局的基因组特征的理解也不断加深。随着抗CD22抗体药物偶联物inotuzumab ozogamicin、CD3-CD19双特异性T细胞衔接抗体blinatumomab、CD19CAR-T 细胞疗法以及强效BCR-ABL1酪氨酸激酶抑制剂ponatinib的发展,年轻和老年ALL患者的前景均已大幅改善。高效药物的可及性提出了一些重要问题,涉及这些药物的最佳联合与序贯方式、其纳入一线方案的策略,以及造血干细胞移植的作用。在这篇综述中,我们讨论了ALL治疗中快速演变的范式,重点介绍了已确立且有效的方案,以及正在进行的临床试验中评估的有前景的新疗法。我们特别关注一线和挽救治疗中正在引领ALL治疗新标准的新型联合方案。

展开英文摘要原文

In the past decade, the available treatments for patients with acute lymphoblastic leukemia (ALL) have rapidly expanded, in parallel with an increased understanding of the genomic features that impact the disease biology and clinical outcomes. With the development of the anti-CD22 antibody-drug conjugate inotuzumab ozogamicin, the CD3-CD19 bispecific T-cell engager antibody blinatumomab, CD19 chimeric antigen receptor T-cell therapy, and the potent BCR-ABL1 tyrosine kinase inhibitor ponatinib, the outlook of ALL in both younger and older adults has substantially improved. The availability of highly effective drugs raised important questions concerning the optimal combination and sequence of these agents, their incorporation into frontline regimens, and the role of hematopoietic stem cell transplantation. In this review, we discuss the rapidly evolving paradigms in the treatment of ALL, highlighting both established and effective regimens, as well as promising new therapies that are being evaluated in ongoing clinical trials. We specifically focus on novel combination regimens in both the frontline and salvage settings that are leading to new standards of care in the treatment of ALL.

论文信息

作者
Short NJ、Kantarjian H、Jabbour E
第一作者单位
Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.United States
通讯作者单位
Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. ejabbour@mdanderson.org.United States
文献类型
美国 NIH 资助研究 · 非美国政府资助研究 · 综述
期刊
Leukemia2021 Nov
原文标识
PubMed 34172894 · DOI 10.1038/s41375-021-01277-3