中国当代儿科杂志2025，Vol.27Issue(7)：792-801,10.DOI:10.7499/j.issn.1008-8830.2503021
我如何治疗儿童慢性髓系白血病
How I treat pediatric chronic myeloid leukemia
摘要
Abstract
Pediatric chronic myeloid leukemia(CML)is more aggressive than adult CML,with unique molecular characteristics and a higher propensity for lymphoid blast crisis.The application of tyrosine kinase inhibitors(TKIs)has significantly improved the prognosis of pediatric CML.Based on international consensus and clinical experience,this article proposes standardized diagnosis and treatment recommendations for pediatric CML,covering initial therapy selection,efficacy evaluation,drug switching,and management of adverse effects.Allogeneic hematopoietic stem cell transplantation(allo-HSCT)is recommended only for patients with disease progression or failure of multiple lines of TKI therapy.For children newly diagnosed with CML in accelerated phase,high-dose imatinib or second-generation TKIs are recommended as first-line therapy.Those achieving optimal responses should continue maintenance therapy,while non-responders require switching to alternative TKIs and consider allo-HSCT.For blast-phase CML,induction therapy requires a combination of TKIs and chemotherapy,with allo-HSCT serving as the core curative intervention.This article highlights common but challenging problems(poor response,drug intolerance,and disease progression)in pediatric CML treatment using three typical cases,aiming to optimize treatment strategies.Furthermore,the goal of achieving treatment-free remission needs to be further addressed through multi-center clinical studies.关键词
慢性髓系白血病/诊断/治疗/酪氨酸激酶抑制剂/异基因造血干细胞移植/儿童Key words
Chronic myeloid leukemia/Diagnosis/Treatment/Tyrosine kinase inhibitor/Allogeneic hematopoietic stem cell transplantation/Child引用本文复制引用
安文彬,杨文钰..我如何治疗儿童慢性髓系白血病[J].中国当代儿科杂志,2025,27(7):792-801,10.基金项目
中国医学科学院医学与健康科技创新工程项目(2023-I2M-C&T-B-106 （）
2021-I2M-1-003). （）
