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首页> 外文期刊>Advances in cell and gene therapy. >Advances in measurable residual disease monitoring for adult acute lymphoblastic leukemia
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Advances in measurable residual disease monitoring for adult acute lymphoblastic leukemia

机译：成人急性淋巴细胞白血病的可测量残留疾病监测的进展

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Adult acute lymphoblastic leukemia management has traditionally relied upon pre-treatment conventional risk factors for treatment decisions. Despite using intensive multiagent chemotherapy followed by a prolonged maintenance or allogeneic stem cell transplantation, these patients remain at a high risk of relapse. Improved techniques for detection of measurable residual disease (MRD) have tremendously changed the posttreatment disease burden assessment and evolved as a powerful predictor of relapse and survival superseding historical prognostic factors. Moreover, MRD measurement has become an integral part of risk stratification, prognosis assessment, intensification or de-escalation of treatment, monitoring of disease burden, and an endpoint in clinical trials. With existing approaches like allogeneic hemat-opoietic stem cell transplantation and emergence of novel agents (eg, blinatumomab, inotuzumab ozogamicin, and chimeric antigen receptor [CAR] T cells) that are highly effective in eradicating residual disease, understanding the role of MRD in treatment decisions is getting more and more important and complex. This review will highlight the advances that have been achieved in MRD monitoring over the years and the practical applications in different time points of treatment to provide a framework for rational management decisions by practicing hematologists and oncologists.
机译：成人急性淋巴细胞白血病管理传统上依靠治疗前的治疗危险因素来进行治疗决策。尽管进行了强化的多构化疗，然后进行了长时间的维持或同种异体干细胞移植，但这些患者仍处于复发的高风险。改进的检测可测量残留疾病（MRD）的技术已极大地改变了治疗后的疾病负担评估，并演变为复发和生存取代历史预后因素的有力预测指标。此外，MRD测量已成为风险分层，预后评估，加强或降低治疗，疾病负担的监测以及临床试验中的终点的组成部分。采用现有方法，例如同种异性血压干细胞移植和新型剂的出现（例如，blinatumomab，inotuzumab ozogamicin和嵌合抗原受体[CAR] T细胞），这些抗原受体[CAR] T细胞在消除残留疾病中非常有效，了解MRD在治疗中的作用决策越来越重要和复杂。这篇综述将强调多年来MRD监测中所取得的进步以及不同时间点的实际应用，以通过实践血液学家和肿瘤学家为理性管理决策提供框架。

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