V．成人急性リンパ性白血病（ALL）―診断と治療の目覚ましい進歩
・フィラデルフィア染色体（Philadelphia chromosome：Ph）陽性急性リンパ性白血病（acute lymphoblastic leukemia：ALL）とPh陰性ALLでは大きく治療方針が異なり，ALLの診断後，早期にPhの有無を判定することが必要である．・Ph陰性ALLに対しては，多剤併用化学療法を行う．・思春期・若年成人ALLは，小児プロトコールで治療することが望ましい．・Ph陽性ALLは，60歳以上の高齢者でも，チロシンキナーゼ阻害薬（tyrosine kinase inhibitor：TKI）を使用することにより，高率に完全寛解に導入できる．...
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| Published in | 日本内科学会雑誌 Vol. 107; no. 7; pp. 1301 - 1308 |
|---|---|
| Main Author | |
| Format | Journal Article |
| Language | Japanese |
| Published |
一般社団法人 日本内科学会
10.07.2018
|
| Subjects | |
| Online Access | Get full text |
| ISSN | 0021-5384 1883-2083 |
| DOI | 10.2169/naika.107.1301 |
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| Abstract | ・フィラデルフィア染色体（Philadelphia chromosome：Ph）陽性急性リンパ性白血病（acute lymphoblastic leukemia：ALL）とPh陰性ALLでは大きく治療方針が異なり，ALLの診断後，早期にPhの有無を判定することが必要である．・Ph陰性ALLに対しては，多剤併用化学療法を行う．・思春期・若年成人ALLは，小児プロトコールで治療することが望ましい．・Ph陽性ALLは，60歳以上の高齢者でも，チロシンキナーゼ阻害薬（tyrosine kinase inhibitor：TKI）を使用することにより，高率に完全寛解に導入できる． |
|---|---|
| AbstractList | ・フィラデルフィア染色体（Philadelphia chromosome：Ph）陽性急性リンパ性白血病（acute lymphoblastic leukemia：ALL）とPh陰性ALLでは大きく治療方針が異なり，ALLの診断後，早期にPhの有無を判定することが必要である．・Ph陰性ALLに対しては，多剤併用化学療法を行う．・思春期・若年成人ALLは，小児プロトコールで治療することが望ましい．・Ph陽性ALLは，60歳以上の高齢者でも，チロシンキナーゼ阻害薬（tyrosine kinase inhibitor：TKI）を使用することにより，高率に完全寛解に導入できる． |
| Author | 長藤, 宏司 |
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| Copyright | 2018 一般社団法人 日本内科学会 |
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| DOI | 10.2169/naika.107.1301 |
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| References | 9) Huguet F, et al: Pediatric-inspired therapy in adults with Philadelphia chromosome-negative acute lymphoblastic leukemia: the GRAALL-2003 study. J Clin Oncol 27: 911-918, 2009. 2) Bennett JM, et al: Proposals for the classification of the acute leukaemias. French-American-British (FAB) co-operative group. Br J Haematol 33: 451-458, 1976. 13) Jabbour E, et al: Combination of hyper-CVAD with ponatinib as first-line therapy for patients with Philadelphia chromosome-positive acute lymphoblastic leukaemia: a single-centre, phase 2 study. The Lancet Oncol 16: 1547-1555. 2015. 5) Pui CH, Evans WE: Treatment of acute lymphoblastic leukemia. N Engl J Med 354: 166-178, 2006. 11) Yanada M, et al: High complete remission rate and promising outcome by combination of imatinib and chemotherapy for newly diagnosed BCR-ABL-positive acute lymphoblastic leukemia: a phase II study by the Japan Adult Leukemia Study Group. J Clin Oncol 24: 460-466, 2006. 3) Arber DA, et al: The 2016 revision to the World Health Organization classification of myeloid neoplasms and acute leukemia. Blood 127: 2391, 2016. 10) Nagafuji K, et al: Monitoring of minimal residual disease (MRD) is useful to predict prognosis of adult patients with Ph-negative ALL: results of a prospective study (ALL MRD2002 Study). J Hematol Oncol 6: 14, 2013. 7) Stock W, et al: What determines the outcomes for adolescents and young adults with acute lymphoblastic leukemia treated on cooperative group protocols? A comparison of Children's Cancer Group and Cancer and Leukemia Group B studies. Blood 112: 1646-1654, 2008. 12) Foà R, et al: Dasatinib as first-line treatment for adult patients with Philadelphia chromosome-positive acute lymphoblastic leukemia. Blood 118: 6521-6528, 2011. 4) Iacobucci I, Mullighan CG. Genetic Basis of Acute Lymphoblastic Leukemia. J Clin Oncol 35: 975-983, 2017. 8) Hayakawa F, et al: Markedly improved outcomes and acceptable toxicity in adolescents and young adults with acute lymphoblastic leukemia following treatment with a pediatric protocol: a phase II study by the Japan Adult Leukemia Study Group. Blood Cancer J 4: e252, 2014. 6) van Dongen JJ, et al: Minimal residual disease diagnostics in acute lymphoblastic leukemia: need for sensitive, fast, and standardized technologies. Blood 125: 3996-4009, 2015. 1) Harrison CJ: Cytogenetics of paediatric and adolescent acute lymphoblastic leukaemia. Br J Haematol 144: 147-156, 2009. |
| References_xml | – reference: 4) Iacobucci I, Mullighan CG. Genetic Basis of Acute Lymphoblastic Leukemia. J Clin Oncol 35: 975-983, 2017. – reference: 6) van Dongen JJ, et al: Minimal residual disease diagnostics in acute lymphoblastic leukemia: need for sensitive, fast, and standardized technologies. Blood 125: 3996-4009, 2015. – reference: 5) Pui CH, Evans WE: Treatment of acute lymphoblastic leukemia. N Engl J Med 354: 166-178, 2006. – reference: 9) Huguet F, et al: Pediatric-inspired therapy in adults with Philadelphia chromosome-negative acute lymphoblastic leukemia: the GRAALL-2003 study. J Clin Oncol 27: 911-918, 2009. – reference: 12) Foà R, et al: Dasatinib as first-line treatment for adult patients with Philadelphia chromosome-positive acute lymphoblastic leukemia. Blood 118: 6521-6528, 2011. – reference: 3) Arber DA, et al: The 2016 revision to the World Health Organization classification of myeloid neoplasms and acute leukemia. Blood 127: 2391, 2016. – reference: 1) Harrison CJ: Cytogenetics of paediatric and adolescent acute lymphoblastic leukaemia. Br J Haematol 144: 147-156, 2009. – reference: 8) Hayakawa F, et al: Markedly improved outcomes and acceptable toxicity in adolescents and young adults with acute lymphoblastic leukemia following treatment with a pediatric protocol: a phase II study by the Japan Adult Leukemia Study Group. Blood Cancer J 4: e252, 2014. – reference: 11) Yanada M, et al: High complete remission rate and promising outcome by combination of imatinib and chemotherapy for newly diagnosed BCR-ABL-positive acute lymphoblastic leukemia: a phase II study by the Japan Adult Leukemia Study Group. J Clin Oncol 24: 460-466, 2006. – reference: 10) Nagafuji K, et al: Monitoring of minimal residual disease (MRD) is useful to predict prognosis of adult patients with Ph-negative ALL: results of a prospective study (ALL MRD2002 Study). J Hematol Oncol 6: 14, 2013. – reference: 7) Stock W, et al: What determines the outcomes for adolescents and young adults with acute lymphoblastic leukemia treated on cooperative group protocols? A comparison of Children's Cancer Group and Cancer and Leukemia Group B studies. Blood 112: 1646-1654, 2008. – reference: 13) Jabbour E, et al: Combination of hyper-CVAD with ponatinib as first-line therapy for patients with Philadelphia chromosome-positive acute lymphoblastic leukaemia: a single-centre, phase 2 study. The Lancet Oncol 16: 1547-1555. 2015. – reference: 2) Bennett JM, et al: Proposals for the classification of the acute leukaemias. French-American-British (FAB) co-operative group. Br J Haematol 33: 451-458, 1976. |
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| Snippet | ・フィラデルフィア染色体（Philadelphia chromosome：Ph）陽性急性リンパ性白血病（acute lymphoblastic leukemia：ALL）とPh陰性ALLでは大きく治療方針が異なり，ALLの... |
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| SubjectTerms | チロシンキナーゼ阻害薬 フィラデルフィア染色体 微小残存病変 急性リンパ性白血病 |
| Title | V．成人急性リンパ性白血病（ALL）―診断と治療の目覚ましい進歩 |
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