Author/Editor | Karas Kuželički, Nataša | |
Title | Novi pristopi k zdravljenju akutne limfoblastne levkemije pri otrocih | |
Translated title | New approaches in pediatric acute lymphoblastic leukemia treatment | |
Type | članek | |
Vol. and No. | Letnik 65, št. 5 | |
Publication year | 2014 | |
Volume | str. 368-377 | |
ISSN | 0014-8229 - Farmacevtski vestnik | |
Language | slv | |
Abstract | Akutna limfoblastna levkemija (ALL) je najpogostejši rak otrok starih od 1 do 10 let. Predvsem zaradi uporabe visoko standardiziranih randomiziranih protokolov zdravljenja se je preživetje pediatričnih bolnikov z ALL v zadnji 50 letih izredno povečalo. Kljub temu pa 10-20% bolnikov z rezistentno obliko bolezni doživi relaps in večina teh tudi umre. Preživetje dojenčkov in odraslih z ALL pa je še slabše. Ker s stopnjevanjem agresivnosti obstoječih protokolov ni več možno izboljšati stopnje ozdravljivosti, kljub povečanju pojavnosti neželenih učinkov, je potrebno pri bolnikih z rezistentno ALL uporabiti nove terapijske pristope. Dosedanje klinične študije kažejo, da so najbolj obetavna zdravila, ki delujejo na genetskem in epigenetskem nivoju ter terapija s celicami, ki izražajo himerne antigenske receptorje (CAR), usmerjene izključno proti rakavim celicam. Uporaba omenjenih novih terapij pa bo vsaj še nekaj let ali desetletij omejena na bolnike z rezistentno oz. relapsirano obliko bolezni, predvsem zaradi še nejasnega varnostnega profila.Acute lymphoblastic leukemia (ALL) is the most common cancer in 1 to 10 years old children. The survival rate of pediatric ALL patients has increased over last 50 years due to the application of highly standardized randomization treatment protocols. However, 10-20% of ALL patients will relapse and die in five year period after therapy completion. The survival rate of infants and adults with ALL is even worse. Increasing the cumulative doses of current protocols did not result in the improved survival rate, despite the higher incidence of toxic effects. Therefore, new therapeutic strategies are needed to improve the ALL therapy efficiency. The most promise hold the genetic and epigenetic drugs, as well as therapy with cells expressing chimeric antigen receptors (CAR), directed specifically towards cancer cells. Due to the unclear safety profile of the abovementioned therapeutics, these new approaches will be at first focused only on patients with resistant ALL. | |
Keywords | akutna limfoblastna levkemija radnomizirani protokoli zdravljenja novi terapevtski pristopi acute lymphoblastic leukemia randomized treatment protocols new therapeutic approaches |