成人急性淋巴细胞白血病诊断和治疗之浅见

何静; 胡俊斌

doi:10.13201/j.issn.1004-2806.2022.03.014

成人急性淋巴细胞白血病诊断和治疗之浅见

何静¹,
胡俊斌^1, ,

- 华中科技大学同济医学院附属协和医院血液病研究所(武汉，430022)

详细信息

通讯作者: 胡俊斌，E-mail：luckyjun@medmail.com.cn

中图分类号: R733.71

收稿日期: 2022-02-13

刊出日期: 2022-03-01

My opinion on diagnosis and treatment of adult acute lymphoblastic leukemia

HE Jing¹,
HU Junbin^1, ,

More Information

Corresponding author: HU Junbin, E-mail: luckyjun@medmail.com.cn

Received Date: 13 February 2022

Publish Date: 01 March 2022

摘要

- 急性淋巴细胞白血病 /
- 诊断 /
- 治疗
- acute lymphoblastic leukemia /
- diagnosis /
- treatment

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表 1 ESMO指南(2016)：成人ALL高风险因素

风险因素	高危因素	推荐
患者相关因素
年龄(岁)	＞40/55/65	强制
体能状态(ECOG评分)	＞1	强烈推荐
疾病相关
WBC(×10⁹/L)	＞30(B细胞系)/＞100(T细胞系)	强制
免疫表型(B-T-亚组)	Pro-B/早期和成熟T	强制
细胞遗传学(核型)	Ph+/t(4；11)+/其他不利因素	强制
遗传学	BCR-ABL1+/MLL+/PBX-E2A+Ph-like/IKZF1del/ETP/unmutated NOTCH1	强制推荐(新临床试验)
混合型	累及CNS	强制
应答
皮质类固醇敏感性(预治疗后外周血原始细胞计数)	强的松应答不佳(≥1×10⁹/L)	推荐
早期原始细胞应答(骨髓形态学)	第8~15天原始细胞≥5%	推荐
CR时间(疗程数)	＞1个周期(延迟CR)	强制
MRD[分子/白血病相关免疫表型(LAIP)]	MRD+(诱导治疗后)	强制

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参考文献(11)

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