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重新定义儿童白血病诊疗——风险评估与靶向治疗的创新:一项叙述性综述

英文原题:Redefining pediatric leukemia care - innovations in risk assessment and targeted treatment: a narrative review.

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Redefining pediatric leukemia care - innovations in risk assessment and targeted treatment: a narrative review.

PubMed 2026/01/21(内容时间) Ann Med Surg (Lond) Q2 · IF 1.6(JCR 2025)

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中文摘要

儿童白血病主要包括急性淋巴细胞白血病(ALL)和急性髓系白血病,约占全球儿童癌症的30%。过去十年中,分子和遗传学分析的进展,包括下一代测序和微小残留病监测,改善了风险分层并实现了个体化治疗策略。将这些方法整合到临床实践中,通过指导治疗强度和为目标性干预提供依据,提高了生存率,尤其是对高危患者。靶向治疗,如用于费城染色体阳性ALL的酪氨酸激酶抑制剂、用于复发/难治性病例的CAR-T 细胞疗法,以及如blinatumomab和inotuzumab ozogamicin等单克隆抗体,改变了治疗结局,同时减少了化疗相关毒性。尽管取得了这些进展,挑战仍然存在,包括治疗耐药的发生(如BCR-ABL1和FLT3突变)以及长期不良反应如心脏毒性和第二恶性肿瘤。本叙述性综述总结了风险评价和靶向治疗方面的最新创新,强调了当前挑战,并讨论了优化个体化儿童白血病治疗的未来方向。

展开英文摘要原文

Pediatric leukemia, primarily comprising acute lymphoblastic leukemia (ALL) and acute myeloid leukemia, represents approximately 30% of childhood cancers worldwide. Over the past decade, advances in molecular and genetic profiling, including next-generation sequencing and minimal residual disease monitoring, have refined risk stratification and enabled individualized treatment strategies. Integrating these approaches into clinical practice has improved survival rates, particularly for high-risk patients, by guiding therapy intensity and informing targeted interventions.

Targeted therapies, such as tyrosine kinase inhibitors for Philadelphia chromosome-positive ALL, Chimeric Antigen Receptor T cell therapy for relapsed or refractory cases, and monoclonal antibodies like blinatumomab and inotuzumab ozogamicin, have transformed treatment outcomes while reducing chemotherapy-related toxicity.

Despite these advances, challenges remain, including the development of therapy resistance (e. g. , BCR-ABL1 and FLT3 mutations) and long-term adverse effects such as cardiotoxicity and secondary malignancies. This narrative review summarizes recent innovations in risk assessment and targeted therapies, highlights current challenges, and discusses future directions to optimize personalized pediatric leukemia care.

论文信息

作者
Obeagu EI
单位
Department of Molecular Medicine and Haematology, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.South Africa
文献类型
综述
期刊
Annals of medicine and surgery (2012)2026 Feb
原文标识
PubMed 41675902 · DOI 10.1097/MS9.0000000000004742