CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
急性白血病的中枢神经系统预防与治疗
英文原题：Central Nervous System Prophylaxis and Treatment in Acute Leukemias.
查看英文原题
Central Nervous System Prophylaxis and Treatment in Acute Leukemias.
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中文摘要
急性淋巴细胞白血病（ALL）和急性髓系白血病（AML）的全身治疗不断改进，改善了患者结局并降低中枢神经系统（CNS）复发率。然而，CNS受累患者的管理仍具挑战性，CNS复发后也难以挽救。除使用可穿透CNS的全身治疗药物（大剂量甲氨蝶呤和阿糖胞苷）外，所有ALL患者均应接受鞘内预防治疗；而没有高危特征的AML患者则未普遍接受该治疗。放疗在CNS预防中的作用有限；但对于CNS受累患者，可考虑将放疗用于巩固治疗或缓解症状。随着细胞治疗时代到来，有必要重新评估既定治疗模式，并研究将放疗作为桥接治疗的作用，尤其针对化疗难治患者。
展开英文摘要原文
Improvements in systemic therapy in the treatment of acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML) have improved patient outcomes and reduced the incidence of CNS relapse.
However, management of patients with CNS disease remains challenging, and relapses in the CNS can be difficult to salvage.
In addition to treatment with CNS-penetrant systemic therapy (high-dose methotrexate and cytarabine), intrathecal prophylaxis is indicated in all patients with ALL, however is not uniformly administered in patients with AML without high-risk features.
There is a limited role for radiation treatment in CNS prophylaxis; however, radiation should be considered for consolidative treatment in patients with CNS disease, or as an option for palliation of symptoms. Re-examining the role of established treatment paradigms and investigating the role of radiation as bridging therapy in the era of cellular therapy, particularly in chemotherapy refractory patients, is warranted.
论文信息
- 作者
- Wu SY、Short NJ、Nasr L、Dabaja BS、Fang PQ
- 单位
- The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA. sywu1@mdanderson.org.United States
- 文献类型
- 综述
- 期刊
- Current treatment options in oncology2022 Dec
- 原文标识
- PubMed 36510037 · DOI 10.1007/s11864-022-01032-5
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