Optimized treatment of childhood B-lineage acute lymphoblastic leukemia

ZHU Xiao-Fan

doi:10.7499/j.issn.1008-8830.2211041

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Chinese Journal of Contemporary Pediatrics ›› 2023, Vol. 25 ›› Issue (4) : 344-349. DOI: 10.7499/j.issn.1008-8830.2211041

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Optimized treatment of childhood B-lineage acute lymphoblastic leukemia

ZHU Xiao-Fan

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Abstract

Childhood acute lymphoblastic leukemia (ALL) accounts for about 75% of childhood leukemia cases, and B-lineage acute lymphoblastic leukemia (B-ALL) accounts for more than 80% of childhood ALL cases. Over the past half century, new molecular biological targets discovered by new techniques have been used in precise stratification of disease prognosis, and there has been a gradual increase in the 5-year overall survival rate of childhood ALL. With the increasing attention to long-term quality of life, the treatment of childhood B-ALL has been constantly optimized from induction therapy to the intensity of maintenance therapy, including the treatment of extramedullary leukemia without radiotherapy, which has been tried with successful results. The realization of optimized treatment also benefits from the development of new techniques associated with immunology and molecular biology and the establishment of standardized clinical cohorts and corresponding biobanks. This article summarizes the relevant research on the implementation of precise stratification and the intensity reduction and optimization treatment of B-ALL in recent years, providing reference for clinicians. Citation:Chinese Journal of Contemporary Pediatrics, 2023, 25(4): 344-349

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B-lineage acute lymphoblastic leukemia / Optimized treatment / Child

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ZHU Xiao-Fan. Optimized treatment of childhood B-lineage acute lymphoblastic leukemia[J]. Chinese Journal of Contemporary Pediatrics. 2023, 25(4): 344-349 https://doi.org/10.7499/j.issn.1008-8830.2211041

References

1 倪鑫. 国家儿童肿瘤监测年报2020[M]. 北京: 人民卫生出版社, 2021.
2 Inaba H, Pui CH. Advances in the diagnosis and treatment of pediatric acute lymphoblastic leukemia[J]. J Clin Med, 2021, 10(9): 1926. PMID: 33946897. PMCID: PMC8124693. DOI: 10.3390/jcm10091926.
3 中国抗癌协会小儿肿瘤专业委员会急性淋巴细胞白血病2015多中心研究协作组. CCCG-ALL-2015方案多中心临床报告[J]. 中华儿科杂志, 2022, 60(10): 1002-1010. PMID: 36207846. DOI: 10.3760/cma.j.cn112140-20220719-00895.
4 邹尧, 陈晓娟, 刘晓明, 等. 单中心应用CCLG-ALL2008方案治疗940例儿童急性淋巴细胞白血病的长期疗效分析[J].中国实验血液学杂志, 2020, 28(4): 1075-1080. DOI: 10.19746/j.cnki.issn1009-2137.2020.04.001.
5 Li XY, Li JQ, Luo XQ, et al. Reduced intensity of early intensification does not increase the risk of relapse in children with standard risk acute lymphoblastic leukemia—a multi-centric clinical study of GD-2008-ALL protocol[J]. BMC Cancer, 2021, 21(1): 59. PMID: 33435902. PMCID: PMC7805214. DOI: 10.1186/s12885-020-07752-x.
6 Tran TH, Hunger SP. The genomic landscape of pediatric acute lymphoblastic leukemia and precision medicine opportunities[J]. Semin Cancer Biol, 2022, 84: 144-152. PMID: 33197607. DOI: 10.1016/j.semcancer.2020.10.013.
7 Brady SW, Roberts KG, Gu Z, et al. The genomic landscape of pediatric acute lymphoblastic leukemia[J]. Nat Genet, 2022, 54(9): 1376-1389. PMID: 36050548. PMCID: PMC9700506. DOI: 10.1038/s41588-022-01159-z.
8 Zhang Y, Gao Y, Zhang H, et al. PDGFRB mutation and tyrosine kinase inhibitor resistance in Ph-like acute lymphoblastic leukemia[J]. Blood, 2018, 131(20): 2256-2261. PMID: 29434033. PMCID: PMC5958655. DOI: 10.1182/blood-2017-11-817510.
9 Tanaka K, Kato I, Dobashi Y, et al. The first Japanese biobank of patient-derived pediatric acute lymphoblastic leukemia xenograft models[J]. Cancer Sci, 2022, 113(11): 3814-3825. PMID: 35879192. PMCID: PMC9633318. DOI: 10.1111/cas.15506.
10 Zhang Y, Wang S, Zhang J, et al. Elucidating minimal residual disease of paediatric B-cell acute lymphoblastic leukaemia by single-cell analysis[J]. Nat Cell Biol, 2022, 24(2): 242-252. PMID: 35145224. DOI: 10.1038/s41556-021-00814-7.
11 Mehtonen J, Teppo S, Lahnalampi M, et al. Single cell characterization of B-lymphoid differentiation and leukemic cell states during chemotherapy in ETV6-RUNX1-positive pediatric leukemia identifies drug-targetable transcription factor activities[J]. Genome Med, 2020, 12(1): 99. PMID: 33218352. PMCID: PMC7679990. DOI: 10.1186/s13073-020-00799-2.
12 Bartram J, Patel B, Fielding AK. Monitoring MRD in ALL: methodologies, technical aspects and optimal time points for measurement[J]. Semin Hematol, 2020, 57(3): 142-148. PMID: 33256904. DOI: 10.1053/j.seminhematol.2020.06.003.
13 Short NJ, Kantarjian H, Ravandi F, et al. High-sensitivity next-generation sequencing MRD assessment in ALL identifies patients at very low risk of relapse[J]. Blood Adv, 2022, 6(13): 4006-4014. PMID: 35533262. PMCID: PMC9278301. DOI: 10.1182/bloodadvances.2022007378.
14 Angiolillo AL, Schore RJ, Kairalla JA, et al. Excellent outcomes with reduced frequency of vincristine and dexamethasone pulses in standard-risk B-lymphoblastic leukemia: results from Children's Oncology Group AALL0932[J]. J Clin Oncol, 2021, 39(13): 1437-1447. PMID: 33411585. PMCID: PMC8274746. DOI: 10.1200/JCO.20.00494.
15 Shen S, Chen X, Cai J, et al. Effect of dasatinib vs imatinib in the treatment of pediatric philadelphia chromosome-positive acute lymphoblastic leukemia: a randomized clinical trial[J]. JAMA Oncol, 2020, 6(3): 358-366. PMID: 31944221. PMCID: PMC6990720. DOI: 10.1001/jamaoncol.2019.5868.
16 Yang W, Cai J, Shen S, et al. Pulse therapy with vincristine and dexamethasone for childhood acute lymphoblastic leukaemia (CCCG-ALL-2015): an open-label, multicentre, randomised, phase 3, non-inferiority trial[J]. Lancet Oncol, 2021, 22(9): 1322-1332. PMID: 34329606. PMCID: PMC8416799. DOI: 10.1016/S1470-2045(21)00328-4.
17 Zhuang Y, Wu K, Zhu X, et al. Reduced dose intensity of daunorubicin during remission induction for low-risk patients with acute lymphoblastic leukemia: a retrospective cohort study of the Chinese Children's Cancer Group[J]. Front Oncol, 2022, 12: 911567. PMID: 35747795. PMCID: PMC9209708. DOI: 10.3389/fonc.2022.911567.
18 Wan Y, Zhang H, Zhang L, et al. Extended vincristine and dexamethasone pulse therapy may not be necessary for children with TCF3-PBX1 positive acute lymphoblastic leukaemia[J]. Br J Haematol, 2022, 199(4): 587-596. PMID: 36114009. PMCID: PMC9649883. DOI: 10.1111/bjh.18437.
19 杨文钰, 郭晔, 陈晓娟, 等. 儿童急性淋巴细胞白血病患儿脑脊液状态与预后的关系[J]. 中国当代儿科杂志, 2020, 22(4): 350-354. PMID: 32312374. PMCID: PMC7389698. DOI: 10.7499/j.issn.1008-8830.1910157.
20 Yeh TC, Liang DC, Hou JY, et al. Treatment of childhood acute lymphoblastic leukemia with delayed first intrathecal therapy and omission of prophylactic cranial irradiation: results of the TPOG-ALL-2002 study[J]. Cancer, 2018, 124(23): 4538-4547. PMID: 30303520. DOI: 10.1002/cncr.31758.
21 Tang J, Yu J, Cai J, et al. Prognostic factors for CNS control in children with acute lymphoblastic leukemia treated without cranial irradiation[J]. Blood, 2021, 138(4): 331-343. PMID: 33684941. PMCID: PMC8323972. DOI: 10.1182/blood.2020010438.
22 Nguyen HTK, Terao MA, Green DM, et al. Testicular involvement of acute lymphoblastic leukemia in children and adolescents: diagnosis, biology, and management[J]. Cancer, 2021, 127(17): 3067-3081. PMID: 34031876. PMCID: PMC9677247. DOI: 10.1002/cncr.33609.
23 Chen X, Wang Y, Ruan M, et al. Treatment of testicular relapse of B-cell acute lymphoblastic leukemia with CD19-specific chimeric antigen receptor T cells[J]. Clin Lymphoma Myeloma Leuk, 2020, 20(6): 366-370. PMID: 32205078. PMCID: PMC8312220. DOI: 10.1016/j.clml.2019.10.016.