Abstract：
Management of acute lymphoblastic leukemia (ALL) patients in countries with limited resources depends on the means of prognostic stratification, available treatment and logistics. During the 12th annual harmonization workshops of the francophone Society of bone marrow transplantation and cellular therapy (SFGM-TC), a designated working group reviewed the literature in order to elaborate unified guidelines for allogeneic hematopoietic cell transplantation (Allo-HCT) in this disease. Conventional poor prognostic factors can be used to determine the indication of allo-HCT in first remission. Patients lacking a HLA-matched related donor can be allografted with a haploidentical donor allo-HCT if available. Chemotherapy based conditioning regimen can be used if TBI is not available, because the probability to find a radiotherapy department with the capacity for total body irradiation is low. For patients with Philadelphia chromosome positive (Phi+) ALL, post-transplantation tyrosine kinase inhibitors as a systematic maintenance strategy is recommended. Autologous HCT is optional for Phi+ ALL patients with negative minimal residual disease, who not eligible for allo-HCT. Patients with refractory/relapsed disease have a poor prognosis which highlights the importance of acquiring in the future new therapies such as: blinatumumab, inotuzumab, and CAR-T cells.
摘要：
在资源有限的国家，急性淋巴细胞白血病（ALL）患者的管理取决于预后分层的方法，可用的治疗和后勤。在法语国家骨髓移植和细胞治疗协会（SFGM-TC）的第12届年度协调研讨会上，一个指定的工作组回顾了文献,以便详细阐述针对该疾病的异基因造血细胞移植(Allo-HCT)的统一指南.常规不良预后因素可用于确定首次缓解时allo-HCT的指征。如果有的话,缺乏HLA匹配的相关供体的患者可以用单倍体相同的供体allo-HCT进行同种异体移植。如果TBI不可用，可以使用基于化疗的预处理方案。因为找到具有全身照射能力的放射治疗部门的可能性很低。对于费城染色体阳性（Phi+）ALL的患者，建议将移植后酪氨酸激酶抑制剂作为系统的维持策略。自体HCT对于微小残留病阴性的Phi+ALL患者是可选的，没有资格获得allo-HCT的人。患有难治性/复发性疾病的患者预后不良，这凸显了在未来获得新疗法的重要性，例如：blinatumumab，伊托珠单抗，和CAR-T细胞。
