Acute Lymphoblastic Leukemia and Acute Lymphoblastic Lymphoma: Same Disease Spectrum but Two Distinct Diagnoses.

IF 2.7 3区医学 Q2 HEMATOLOGY

Current Hematologic Malignancy Reports Pub Date : 2021-10-01 Epub Date: 2021-08-21 DOI:10.1007/s11899-021-00648-y

Kathryn A F Kline, Michael E Kallen, Vu H Duong, Jennie Y Law

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引用次数: 1

Abstract

Purpose of review: Rare malignancies developing from lymphocyte precursor cells, lymphoblastic leukemia (LBL), and acute lymphoblastic lymphoma (ALL) have historically been viewed as different manifestations of the same disease process. This review examines data on their epidemiology, genetics, clinical presentation, and response to treatment while highlighting areas of similarity and divergence between these two clinical entities.

Recent findings: Pediatric-type ALL chemotherapy regimens, compared to both lymphoma-type chemotherapy and adult-type ALL regimens, have led to improved outcomes for children, adolescents, and young adults with ALL. BCR-ABL-targeting tyrosine kinase inhibitors (TKIs) have improved outcomes in Philadelphia chromosome-positive (Ph +) ALL and in rare cases of Ph + LBL. Newer therapies including blinatumomab, inotuzumab, CAR-T therapy, and nelarabine have improved outcomes in selected cases of ALL and have an emerging role in the management of LBL. Better understanding of ALL and LBL biology allows for the development of therapies that target immunophenotypic or genetic features found in subsets of both diseases. Novel therapies are leading to improved outcomes in Ph + and relapsed and refractory disease.

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急性淋巴母细胞白血病和急性淋巴母细胞淋巴瘤:相同的疾病谱系但两种不同的诊断。

回顾目的:从淋巴细胞前体细胞、淋巴母细胞白血病(LBL)和急性淋巴母细胞淋巴瘤(ALL)发展而来的罕见恶性肿瘤历来被视为同一疾病过程的不同表现。这篇综述检查了他们的流行病学、遗传学、临床表现和治疗反应的数据，同时强调了这两个临床实体之间的相似和差异。最近的研究发现:与淋巴瘤型化疗和成人型ALL方案相比，儿科型ALL化疗方案改善了儿童、青少年和年轻人ALL的预后。靶向bcr - abl的酪氨酸激酶抑制剂(TKIs)改善了费城染色体阳性(Ph +) ALL和罕见的Ph + LBL病例的预后。包括blinatumomab、inotuzumab、CAR-T疗法和奈拉滨在内的新疗法改善了部分ALL病例的预后，并在LBL的治疗中发挥了新的作用。更好地了解ALL和LBL生物学，可以开发针对两种疾病亚群中发现的免疫表型或遗传特征的治疗方法。新疗法正在改善Ph +和复发和难治性疾病的预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Hematologic Malignancy Reports ONCOLOGY-HEMATOLOGY

CiteScore

6.00

自引率

0.00%

发文量

审稿时长

>12 weeks

期刊介绍： his journal intends to provide clear, insightful, balanced contributions by international experts that review the most important, recently published clinical findings related to the diagnosis, treatment, management, and prevention of hematologic malignancy. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as leukemia, lymphoma, myeloma, and T-cell and other lymphoproliferative malignancies. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research. Commentaries from well-known figures in the field are also provided.