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The 3rd China Hematology Development Conference was held
offline and online on January 6~8.
Professor Zhu Xiaofan from the Hospital of Hematology, Chinese Academy of Medical Sciences (Institute of Hematology, Chinese Academy of Medical Sciences) gave a wonderful report
on the topic of pediatric hematology.
Yimaitong sincerely invited Professor Zhu Xiaofan to be interviewed to talk about the latest research progress and future clinical research plans
of childhood acute lymphoblastic leukemia (ALL) based on the latest research data at the 2022 American Society of Hematology Annual Meeting (ASH).
Professor Zhu Xiaofan
Chief physician, doctoral supervisor
Director of the Pediatric Hematology Diagnosis and Treatment Center of the Hematology Hospital of the Chinese Academy of Medical Sciences (Institute of Hematology, Chinese Academy of Medical Sciences).
Vice Chairman of the Pediatric Hematology Expert Committee of the National Health Commission
Chairman-elect of Pediatric Hematological Oncology Professional Committee of Chinese Anti-Cancer Association
Leader of Hematology Group, Pediatrics Branch of Tianjin Medical Association
Vice Chairman of Tianjin Pediatric Oncology Professional Committee
Editorial board member of Chinese Journal of Pediatrics, Chinese Journal of Hematology and other journals
Tianjin has experts with outstanding contributions
He has won the second prize of National Natural Science Award, Song Qingling Pediatric Medicine Award, Tianjin Natural Science First Prize and other awards
ALL is the most common malignant tumor in children, and its diagnosis and treatment and prognosis are different from adult patients.
Professor Zhu Xiaofan
The treatment effect of pediatric ALL is better than that of adult ALL patients, and pediatric ALL, as the main disease of childhood leukemia, can achieve a high survival rate
through conventional chemotherapy.
The disease-free survival (DFS) rate of more than five years of domestic children with ALL can reach more than 85%, and the overall survival (OS) rate is close to 90%, but there are still about 20% of patients due to treatment differences or irregular treatment leading to disease recurrence, which is one of
the difficulties in current diagnosis and treatment.
In clinical practice, we have seen that some patients use informal drugs for treatment, and irregular treatment may lead to the recurrence of the patient's disease, which may bring some adverse effects
to later treatment.
Therefore, ALL patients are called upon to receive standardized treatment
under the guidance of doctors.
Yimaitong: At this year's China Hematology Development Conference, you shared the latest progress in pediatric hematology, what progress is worth paying attention to in the diagnosis and treatment of pediatric ALL?
Professor Zhu Xiaofan
The progress on ALL in children at the 2022 ASH Conference mainly includes three aspects
: new mechanisms (omic type mapping and prognostic molecular markers), new strategies (chemotherapy optimization, targeted therapy and cellular immunotherapy) and new technologies (artificial intelligence and high-throughput drug screening).
Children's ALL is dominated by B cell lines, and children's B-cell ALL (B-ALL) accounts for about
80% of children's ALL.
In the treatment of B-ALL, there have been new advances in emerging immunotherapy and prognostic stratification, and small molecule targeted drugs combined with immunotherapy have shown better research data
than traditional treatment in Philadelphia chromosome-positive children B-ALL (Ph+ children B-ALL).
In addition, Chinese researchers reported a number of treatment progress
on chimeric antigen receptor T cell immunotherapy (CAR-T) for B-ALL at the ASH conference in 2022.
Children's T cell ALL (T-ALL) accounts for about
10%-20% of children's ALL.
Children with T-ALL are classified as intermediate-risk in previous treatments, with approximately 70% of patients in the intermediate-risk group achieving remission and approximately 30% progressing to relapsed refractory ALL
after receiving conventional chemotherapy.
Several advances
in the treatment of T-ALL were reported at ASH 2022.
Although immunotherapy has been applied in the treatment of T-ALL in children, there are still unbroken barriers
.
St.
Jude Children's Hospital in the United States shared the latest research progress of whole genome sequencing and whole transcriptome sequencing of T-ALL, mainly in-depth research on the detailed typing and prognosis related biological targets of T-ALL, which may have a profound impact on the future development of precise diagnosis and targeted therapy of T-ALL, and was also selected as the Best of ASH
.
The story of Emily, the world's first little girl who received CAR-T cell therapy, has long been popular, and Chinese pediatric ALL patients and their families are increasingly aware of new drug clinical research.
Professor Zhu Xiaofan
The use of immunotargeted therapy in first-line treatment of ALL improves the survival and quality of life of patients, and reducing the use of chemotherapy can reduce the damage
to the human body.
Although immunotherapy offers promise for pediatric ALL, treatment options for pediatric patients with relapsed/refractory (R/R) ALL remain limited
.
The Institute has been committed to the treatment of R/R and high-risk ALL for many years, and has carried out a series of studies, including the ongoing clinical trial of R/R T-ALL, a randomized controlled multi-center study led by the Institute of Blood Research in the treatment of high-risk T-ALL, a clinical study of BCL-2 inhibitors in the treatment of R/R B/T-ALL, and a clinical trial of domestic third-generation TKI orebatinib combined with BCL-2 inhibitors in the treatment of R/R Ph+B-ALL.
and three ongoing CAR-T treatment studies
.
: Cherry Reviewed: Mia Typesetting: Cherry Execution: Quinta
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Poke "Read Original" to watch the wonderful replay of the meeting