GCF Chan, CH Pui

Abstract

Acute lymphoblastic leukaemia (ALL) is the commonest form of childhood malignancy with an estimated annual incidence of 40 to 50 new cases (<15 years) in Hong Kong. The cure rate for ALL in children has improved drastically over the past 2 decades and is approaching 70% currently. Well-designed collaborative clinical trials had contributed greatly to this success in treatment outcome. The advances in new technology especially in the field of molecular biology also help to revolutionise the process of risk assessment, treatment stratification and disease monitoring. In addition to the advances in treatment, progresses had also been made in the understanding of leukaemogenesis and its associated risk factors, individual susceptibility and prognosis assessment. But while there are more and more childhood ALL children being cured, long-term therapy-related complications starts to emerge and becomes a new challenge. This review article will mainly focus on the recent advances in the areas of leukaemogenesis, prognostic assessment, current treatment design and late effect of ALL management.

急性淋巴細胞白血病是兒童期最常見的惡性腫瘤，香港每年大約有 40 至 50 個新發病例(<15 歲)。近二十年來，兒童急性淋巴細胞白血病的治愈率明顯提高，現在已達 70%。治療的成功很大程度得益於精心設計的綜合臨床試驗。新技術的進展，尤其在分子生物學領域的進展；大大幫助了對危險性的評估、治療方案的選擇以及疾病的監測。此外，白血病發病機理、相關危險因素、個體易感性和預後評估方面的研究也取得進展。然而，隨著越來越多患兒得到治愈，治療引起的遠期併發症日益受到重視。本綜述主要總結在白血病發生、預後評估、目前治療方案以及治療遠期後果方面的進展。