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急性淋巴细胞白血病

英文原题:Acute lymphoblastic leukaemia.

查看英文原题

Acute lymphoblastic leukaemia.

PubMed 2024/06/13(内容时间) Nat Rev Dis Primers Q1 · IF 79.8(JCR 2025)

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中文摘要

急性淋巴细胞白血病(ALL)是一种以未成熟淋巴细胞不受控制增殖为特征的血液系统恶性肿瘤。过去几十年来,在理解 ALL 生物学方面取得了重大进展,使其诊断、治疗和监测得到了显著改善。自化疗问世以来,ALL 一直是测试适用于一般癌症的创新方法的平台。例如,组学医学的出现使人们对支撑 ALL 的分子和遗传特征有了更深入的理解。基因组分析技术的创新已识别出驱动 ALL 的特定遗传改变和突变,激发了新的疗法。靶向药物,如酪氨酸激酶抑制剂和免疫疗法,已在患者亚组中显示出有希望的结果,同时将不良反应降至最低。

此外,CAR-T 细胞疗法的发展代表了 ALL 治疗的突破,带来了显著的缓解和潜在的长期缓解。进展不仅限于治疗方式。可测量残留病监测和离体药物反应谱筛选提供了疾病复发的更早期检测和异常应答者的识别,使临床医生能够为个体患者调整治疗策略。数十年的支持性和预防性护理改善了治疗相关并发症的管理,提高了 ALL 患者的生活质量。

展开英文摘要原文

Acute lymphoblastic leukaemia (ALL) is a haematological malignancy characterized by the uncontrolled proliferation of immature lymphoid cells. Over past decades, significant progress has been made in understanding the biology of ALL, resulting in remarkable improvements in its diagnosis, treatment and monitoring. Since the advent of chemotherapy, ALL has been the platform to test for innovative approaches applicable to cancer in general.

For example, the advent of omics medicine has led to a deeper understanding of the molecular and genetic features that underpin ALL. Innovations in genomic profiling techniques have identified specific genetic alterations and mutations that drive ALL, inspiring new therapies. Targeted agents, such as tyrosine kinase inhibitors and immunotherapies, have shown promising results in subgroups of patients while minimizing adverse effects.

Furthermore, the development of chimeric antigen receptor T cell therapy represents a breakthrough in ALL treatment, resulting in remarkable responses and potential long-term remissions. Advances are not limited to treatment modalities alone.

Measurable residual disease monitoring and ex vivo drug response profiling screening have provided earlier detection of disease relapse and identification of exceptional responders, enabling clinicians to adjust treatment strategies for individual patients. Decades of supportive and prophylactic care have improved the management of treatment-related complications, enhancing the quality of life for patients with ALL.

论文信息

作者
Pagliaro L、Chen SJ、Herranz D、Mecucci C、Harrison CJ、Mullighan CG、Zhang M、Chen Z
第一作者单位
Department of Medicine and Surgery, University of Parma, Parma, Italy.Italy
通讯作者单位
Department of Medicine and Surgery, University of Parma, Parma, Italy. giovanni.roti@unipr.it.Italy
文献类型
综述
期刊
Nature reviews. Disease primers2024 Jun 13
原文标识
PubMed 38871740 · DOI 10.1038/s41572-024-00525-x