基于慢性淋巴细胞白血病进展模型的成人惰性t细胞白血病/淋巴瘤早期治疗干预展望

IF 6.9 2区 医学 Q1 HEMATOLOGY Blood Reviews Pub Date : 2023-07-01 DOI:10.1016/j.blre.2023.101057
Akihiro Ohmoto , Shigeo Fuji
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引用次数: 0

摘要

成人T细胞白血病/淋巴瘤(ATLL)具有侵袭性临床行为,改善其预后是一个巨大的挑战。已经提出了从无症状的人类T细胞白血病病毒1型携带者到侵袭型ATLL的疾病进展模型,并且包括闷烧型或有利的慢性型的惰性ATLL位于中点。即使是最有利的闷烧类型也具有<;60%。尽管警惕性等待在惰性ATLL患者中普遍存在,但血液学家对早期治疗干预进行了讨论。Indolent ATLL曾被称为T细胞衍生的慢性淋巴细胞白血病(CLL)。与惰性ATLL不同,在最初的治疗中,几种分子靶向药物显著改善了CLL的预后。最近对CLL的研究揭示了一种类似的进展模型,涉及癌前单克隆B细胞淋巴细胞增多症(MBL)。特别是,MBL计数高的个体患淋巴瘤的风险增加。考虑到惰性ATLL的长期预后不令人满意,需要进一步的治疗策略,包括精准药物。
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Prospects of early therapeutic interventions for indolent adult T-cell leukemia/lymphoma based on the chronic lymphocytic leukemia progression model

Adult T-cell leukemia/lymphoma (ATLL) has aggressive clinical behaviors, and improving its prognosis is a great challenge. A disease progression model from asymptomatic human T-cell leukemia virus type 1 carrier to aggressive-type ATLL has been proposed, and indolent ATLL comprising a smoldering or favorable chronic type is located at the midpoint. Even the most favorable smoldering type has a 4-year overall survival rate of <60%. Although watchful waiting is pervasive in patients with indolent ATLL, early therapeutic intervention is discussed among hematologists. Indolent ATLL was once termed T-cell-derived chronic lymphocytic leukemia (CLL). Unlike indolent ATLL, several molecular-targeted agents at the initial treatment have dramatically improved CLL prognosis. Recent studies on CLL have revealed a similar progression model involving premalignant monoclonal B-cell lymphocytosis (MBL). In particular, individuals with high-count MBL have an increased lymphoma risk. Considering the unsatisfactory long-term prognosis of indolent ATLL, further treatment strategies, including precision medicine, are warranted.

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来源期刊
Blood Reviews
Blood Reviews 医学-血液学
CiteScore
13.80
自引率
1.40%
发文量
78
期刊介绍: Blood Reviews, a highly regarded international journal, serves as a vital information hub, offering comprehensive evaluations of clinical practices and research insights from esteemed experts. Specially commissioned, peer-reviewed articles authored by leading researchers and practitioners ensure extensive global coverage across all sub-specialties of hematology.
期刊最新文献
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