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Совершенствование программ терапии острого лимфобластного лейкоза у детей: акцент на минимальную остаточную болезнь

https://doi.org/10.17650/1818-8346-2020-15-3-12-26

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Аннотация

Лечение острого лимфобластного лейкоза у детей за последние 50 лет претерпело существенные изменения, что позволило повысить выживаемость больных с 10–15 % в начале 1960‑х годов до 80–85 % к середине 2000‑х. Подобных результатов удалось добиться благодаря развитию новых режимов полихимиотерапии, введению профилактики нейролейкоза, усилению стандартной химиотерапии путем увеличения дозы и / или частоты введения химиопрепаратов, а также определению критериев стратификации больных на прогностические группы риска и разработке принципов риск-адаптированной терапии.

Несмотря на общий успех терапии, при отдельных вариантах острого лимфобластного лейкоза прогноз заболевания остается плохим, что особенно показательно при обнаружении BCR-ABL1 и MLL. Кроме этого, длительная персистенция минимальной остаточной болезни также является неблагоприятным прогностическим фактором, требующим интенсификации терапии.

В настоящей статье представлены основные этапы эволюции программной химиотерапии острого лимфобластного лейкоза у детей, большое внимание уделено современным риск-стратифицирующим критериям с акцентом на минимальную остаточную болезнь.

Об авторах

М. А. Шервашидзе
НИИ детской онкологии и гематологии ФГБУ «Национальный медицинский исследовательский центр онкологии им. Н. Н. Блохина» Минздрава России
Россия

Мери Алексеевна Шервашидзе

Россия, 115478 Москва, Каширское шоссе, 24



Т. Т. Валиев
НИИ детской онкологии и гематологии ФГБУ «Национальный медицинский исследовательский центр онкологии им. Н. Н. Блохина» Минздрава России
Россия
Россия, 115478 Москва, Каширское шоссе, 24


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Для цитирования:


Шервашидзе М.А., Валиев Т.Т. Совершенствование программ терапии острого лимфобластного лейкоза у детей: акцент на минимальную остаточную болезнь. Онкогематология. 2020;15(3):12-26. https://doi.org/10.17650/1818-8346-2020-15-3-12-26

For citation:


Shervashidze M.A., Valiev T.T. Pediatric acute lymphoblastic leukemia treatment protocols improvement: emphasis on minimal residual disease. Oncohematology. 2020;15(3):12-26. (In Russ.) https://doi.org/10.17650/1818-8346-2020-15-3-12-26

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ISSN 2413-4023 (Online)