Ｂ前駆細胞型急性リンパ性白血病の治療

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  • Treatment of Childhood Acute Lymphoblastic Leukemia with B-Cell Precursor Phenotype

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Although more than 80% of children with acute lymphoblastic leukemia of the B-cell precursor phenotype (BCP-ALL) has been cured by the 4 groups' clinical study in Japan, the remaining 20% of patients underwent some events including induction failure, relapse, secondary cancer and also suffered from late complication. Japanese Pediatric Leukemia/ Lymphoma Study Group (JPLSG) was organized in 2003 and the JPLSG protocols have been already started for three distinct and rare types of ALL, including mature B-ALL, infant ALL and Ph+ALL. We are just planning to start JPLSG T-cell ALL protocol in 2009. For the purpose of finding the standard treatment of BCR-ALL in Japan, central nervous system leukemia directed treatment is important to avoid pre-symptomatic cranial radiotherapy. Then, for the best cure by the best treatment, it is importanr that risk-directed stratification also contain not only age and WBC count at onset, but also genetic subtype of BCP-ALL, early response to treatment and introduction of selected antileukemic drugs being tested in clinical trials.

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