Pediatric acute lymphoblastic leukemia

被引:374
作者
Inaba, Hiroto [1 ,2 ]
Mullighan, Charles G. [2 ,3 ]
机构
[1] St Jude Childrens Res Hosp, Dept Oncol, 332 N Lauderdale St, Memphis, TN 38105 USA
[2] St Jude Childrens Res Hosp, Hematol Malignancies Program, 332 N Lauderdale St, Memphis, TN 38105 USA
[3] St Jude Childrens Res Hosp, Dept Pathol, 332 N Lauderdale St, Memphis, TN 38105 USA
基金
美国国家卫生研究院;
关键词
MINIMAL RESIDUAL DISEASE; CHILDHOOD T-CELL; TRIAL AIEOP-BFM; GENOMIC LANDSCAPE; STANDARD-RISK; LEVOFLOXACIN PROPHYLAXIS; INOTUZUMAB OZOGAMICIN; TUMOR-SUPPRESSOR; SOMATIC MUTATION; YOUNG-ADULTS;
D O I
10.3324/haematol.2020.247031
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The last decade has witnessed great advances in our understanding of the genetic and biological basis of childhood acute lymphoblastic leukemia (ALL), the development of experimental models to probe mechanisms and evaluate new therapies, and the development of more efficacious treatment stratification. Genomic analyses have revolutionized our understanding of the molecular taxonomy of ALL, and these advances have led the push to implement genome and transcriptome characterization in the clinical management of ALL to facilitate more accurate risk-stratification and, in some cases, targeted therapy. Although mutation- or pathway-directed targeted therapy (e.g., using tyrosine kinase inhibitors to treat Philadelphia chromosome [Ph]-positive and Phlike B-cell-ALL) is currently available for only a minority of children with ALL, many of the newly identified molecular alterations have led to the exploration of approaches targeting deregulated cell pathways. The efficacy of cellular or humoral immunotherapy has been demonstrated with the success of chimeric antigen receptor T-cell therapy and the bispecific engager blinatumomab in treating advanced disease. This review describes key advances in our understanding of the biology of ALL and optimal approaches to risk-stratification and therapy, and it suggests key areas for basic and clinical research.
引用
收藏
页码:2524 / 2539
页数:16
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