TKI治疗Ph阳性急性淋巴细胞白血病现状及进展

Current status and progression of TKI in treating Ph-positive acute lymphoblastic leukemia

费城染色体阳性(Ph+)急性淋巴细胞白血病(ALL)有着复发率高、无病生存时间短、预后差等特点。造血干细胞移植(HSCT)一直被认为是治愈Ph+ALL的唯一办法。随着酪氨酸激酶抑制剂(TKI)的出现,Ph+ALL患者的疗效及预后得到显著提高。伊马替尼是第一个在Ph+ALL中靶向BCR-ABL融合基因的TKI,随后逐渐开发了第2代TKI尼罗替尼、达沙替尼、博舒替尼以及第3代TKI普纳替尼。尽管TKI联合化疗在治疗反应方面取得了显著疗效,但频繁的复发、耐药仍然是目前面临的一项挑战。现就近年TKI治疗成人Ph+ALL的进展进行综述如下。

Philadelphia chromosome-positive(Ph+)acute lymphoblastic leukemia(ALL)has the characteristics of high recurrence rate,short disease-free survival time and poor prognosis.Hematopoietic stem cell transplantation(HSCT)has always been considered as the only method for curing Ph+ALL.With the advent of tyrosine kinase inhibitors(TKI),the efficacy and prognosis of the patients with Ph+ALL are significantly improved.Imatinib is the first TKI for targeting BCR-ABL fusion gene in Ph+ALL,whereafter the second-generation TKI nilotinib,dasatinib,bosutinib and third-generation TKI ponatinib are gradually developed.Although TKI combined with chemotherapy has achieved significant therapeutic response,but frequent relapse and drug resistance remain a current challenge.This article reviews the progress of TKI in the treatment of adult Ph+ALL in recent years.