NCCN临床实践指南_急性淋巴细胞白血病(2019.V2)英文版
115页1、Version 2 2019 05 15 19 2019 National Comprehensive Cancer Network NCCN All rights reserved NCCN Guidelines and this illustration may not be reproduced in any form without the express written permission of NCCN NCCN Clinical Practice Guidelines in Oncology NCCN Guidelines Acute Lymphoblastic Leukemia Version 2 2019 May 15 2019 Continue NCCN org NCCN Guidelines Version 2 2019 Acute Lymphoblastic Leukemia Version 2 2019 05 15 19 2019 National Comprehensive Cancer Network NCCN All rights reserved N
2、CCN Guidelines and this illustration may not be reproduced in any form without the express written permission of NCCN NCCN Guidelines Index Table of Contents Discussion Peter F Coccia MD Fred 22 q34 1 q11 2 BCR ABL1 t v 11q23 3 KMT2A rearranged t 12 21 p13 2 q22 1 ETV6 RUNX1 t 1 19 q23 p13 3 TCF3 PBX1 t 5 14 q31 1 q32 3 IL3 IGH B cell lymphoblastic leukemia lymphoma not otherwise specified Provisional entities B lymphoblastic leukemia lymphoma BCR ABL1Ph like B lymphoblastic leukemia lymphoma wi
3、th iAMP21 early T cell precursor lymphoblastic leukemia Footnote d modified While these guidelines pertain primarily to patients with leukemia patients with lymphoblastic lymphoma LL B or T cell would likely also benefit from ALL like regimens versus traditional lymphoma therapy Such patients should be treated in a center that has experience with LL ALL 2 Bullet 10 modified CT of neck chest abdomen pelvis with IV contrast as indicated for symptoms Last bullet modified Strongly consider human leu
4、kocyte antigen HLA typing and early evaluation and search for family or an alternative donor Footnote k modified Timing of LP should be consistent with the chosen treatment regimen Pediatric inspired regimens typically include LP and prophylactic IT chemotherapy at the time of diagnostic workup The panel recommends that first LP be done concurrently with initial IT therapy performed at time of initial scheduled IT therapy unless directed by symptoms to perform earlier ALL 3 Consolidation Therapy
5、 after Complete Response modified Allogeneic HCT if a donor is availablein appropriate candidates or If allogeneic HCT is not available Continue multiagent chemotherapy TKI also applies to ALL 4 Footnote o is new to the page It is reasonable to approach the initial treatment of blast phase CML with similar strategies to Ph ALL with a goal of proceeding to HCT also applies to ALL 4 Footnote u updated with additional reference Footnote v added Many variables determine eligibility for allogeneic HC
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