Integrating molecular information into treatment of childhood acute lymphoblastic leukemia -: A perspective from the BFM Study Group
Integrating molecular information into treatment of childhood acute lymphoblastic leukemia -: A perspective from the BFM Study Group
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DOI：
10.1016/j.bcmd.2007.04.005
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发表时间：
2007-09-01
影响因子：
2.3
通讯作者：
Schrappe, Martin
中科院分区：
文献类型：
--
作者：
Stanulla, Martin;Cario, Gunnar;Schrappe, Martin
急性淋巴细胞性白血病(ALL)是儿童时期最常见的恶性肿瘤，可单用化疗，或特别是亚型，加用放射治疗和/或干细胞移植。根据与所有复发风险相关的预后因素调整治疗强度。根据柏林-法兰克福-蒙斯特(BFM)方案，通过血液或骨髓中白血病细胞的减少来衡量广泛适用的体内早期治疗反应是目前最重要的预后因素。然而，尽管所有采用风险适应方案治疗的儿童的总体长期治愈率在过去几十年中有了显著提高，到目前为止已超过75%，但仍有相当数量的患者死于复发疾病或所用治疗的毒性。未来BFM试验的一个目标将是利用对白血病和宿主特征的更好的分子理解来剖析治疗反应差异的潜在机制。这篇简短的综述集中在BFM试验中治疗反应的演变，并为我们改善儿童ALL的分子特征和实施更个性化和新的治疗方法的战略提供了一个视角。(C)2007 Elsevier Inc.保留所有权利。
Acute lymphoblastic leukemia (ALL) is the most common malignancy of childhood and is treated with chemotherapy alone or, in particular subgroups, with additional radiation therapy and/or stem cell transplantation. The treatment intensity is adjusted according to prognostic factors associated with the risk of ALL recurrence. On Berlin-Frankfurt-Munster (BFM) protocols, the widely applicable early in vivo response to treatment as measured by the reduction of leukemic cells in the blood or bone marrow is currently the most important prognostic factor. However, although overall long-term cure rates for childhood ALL treated on risk-adapted protocols have dramatically improved over the last decades and, to date, are higher than 75%, a significant number of patients still die due to recurrent disease or the toxicity of treatment applied. One goal in future BFM trials will be to take advantage of a better molecular understanding of leukemia and host characteristics to dissect the mechanisms underlying the differences in treatment response. This short review focuses on the evolution of treatment response in BFM trials and provides a perspective on our strategy for improving molecular characterization of childhood ALL and implementing more individualized and novel therapeutic approaches. (C) 2007 Elsevier Inc. All rights reserved.