PDF(Pubmed)
Abstract：
Acute lymphoblastic leukemia (ALL) is the most frequent childhood cancer, with 80-85% represented by B cell ALL and only 15% by T cell ALL. T Cell ALL (T-ALL) carries a more reserved prognosis compared to B Cell ALL (B-ALL) with regard to response to treatment, risk of relapse, and overall survival. Progress made in current monitoring protocols such as via flow cytometry immunophenotyping (FCM) and by PCR-based amplification of antigen-receptor genes led to improved management of patients with ALL and superior rates of survival. Nevertheless, challenges remain in some clinical cases. This manuscript describes a unique case of T-ALL and raises awareness of such clinical challenges. The article presents an overview of the flow cytometry immunophenotyping at diagnosis and during treatment of a pediatric patient with T-ALL from Fundeni Clinical Institute. In this case, in spite of various therapeutic measures such as first-line chemotherapy for high risk group, salvage chemotherapy (FLAG), conditioning regimen (FLU-BU-TT-ATG), and stem cell transplant, a chemoresistance clone continued to be present.
摘要：
急性淋巴细胞白血病（ALL）是最常见的儿童癌症，B细胞ALL代表80-85%，T细胞ALL仅代表15%。与B细胞ALL（B-ALL）相比，T细胞ALL（T-ALL）在对治疗的反应方面具有更有保留的预后，复发的风险，和总体生存率。在当前的监测方案中取得的进展，例如通过流式细胞术免疫表型（FCM）和基于PCR的抗原受体基因扩增，导致对ALL患者的管理得到改善，生存率更高。然而，在一些临床病例中仍然存在挑战。该手稿描述了T-ALL的独特案例，并提高了对此类临床挑战的认识。本文概述了Fundeni临床研究所诊断和治疗小儿T-ALL的流式细胞术免疫表型。在这种情况下,尽管有各种治疗措施，例如对高危人群进行一线化疗，挽救性化疗（FLAG），预处理方案(FLU-BU-TT-ATG),和干细胞移植，化学抗性克隆继续存在。
