In children with acute lymphoblastic leukemia treatment evolution.docVIP

 PAGE \* MERGEFORMAT 9 In children with acute lymphoblastic leukemia treatment evolution Keywords: childhood acute lymphoblastic leukemia Children with acute lymphoblastic leukemia (Acute Lymphoblastic Leukemia, ALL) is the most common malignant tumor in childhood, from the beginning of the last century 50’s, children’s ALL between the continuous optimization of chemotherapy combination chemotherapy program has been continuously updated, and according to different risk sub - Group to select the appropriate chemotherapy, the therapeutic effect of ALL children to be greatly enhanced. To the last century, 90 years, children in developed countries do ALL of the 5-year survival rate (event  free survival, EFS) 70% ~ 80%, the overall cure rate of nearly 80%, the latest research results show that ALL children in the near future, The cure rate of up to 90%. ALL children in the therapeutic effect was able to achieve such a remarkable progress, mainly due to the following four aspects: (1) a more accurate risk classification, according to type selected chemotherapy regimens; (2) the rational combination of chemotherapy drugs, in ensuring the efficacy of the same time, low-risk ALL children in the treatment of patients reduced the strength and control over the entire treatment time, thus reducing drug toxicity; (3) improving the shelter of preventive measures, using systemic high-dose methotrexate (HD  MTX, 5 g/m2) with intrathecal injection, to reduce extramedullary relapse at the same time, so that a considerable part of the brain in children with preventive radiation therapy may be waived in the past, even if those who need radiotherapy also reduced the radiation dose, thereby reducing treatment-related mortality and radiotherapy long-term toxic side effects, improved quality of life; (4) strong support for the treatment, reducing the incidence of chemotherapy-related deaths. A change of chemotherapy The treatment of ALL in ch