JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE) ›› 2022, Vol. 42 ›› Issue (2): 211-217.doi: 10.3969/j.issn.1674-8115.2022.02.012

• Review • Previous Articles    

Progress in research on the mechanism of drug resistance to conventional chemotherapeutic drugs in children with acute lymphoblastic leukemia

Yanyan LIN(), Yan XU, Hui LI()   

  1. Key Laboratory of Pediatric Hematology and Oncology of National Health Commission, Pediatric Translational Medicine Institute, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
  • Received:2021-09-06 Online:2022-02-28 Published:2022-03-17
  • Contact: Hui LI;
  • Supported by:
    National Natural Science Foundation of China(81870116);Rising-Star Program from the Science and Technology Commission of Shanghai Municipality(18QA1402900)


Acute lymphoblastic leukemia (ALL) has the highest incidence of hematological tumors in children, accounting for about one-third of all childhood cancer cases. With the continuous optimization of the treatment plan and the expansion of health care coverage in China, remarkable improvements have been achieved in the treatment of childhood ALL, and the overall survival rate of more than 5 years has reached 90%. Lack of effective treatment and unacceptably high recurrence rate are the leading causes of severe decrease in the survival and quality of life of children with drug resistance. In recent years, pathogenesis and regulation mechanism of ALL drug resistance has become a hot topic and a difficulty of research at home and abroad. Studies have shown that children with ALL may not only antagonize a certain chemotherapy (chemotherapeutic) drug, but also have a thorny situation of multi-drug resistance. Therefore, it is of great significance to improve the research on the mechanism of drug resistance of ALL to improve the prognosis of children with ALL. This review summarizes recent research progress in drug resistance mechanisms of conventional chemotherapy drugs for childhood ALL, including hormones, antimetabolite drugs (folate antagonists, thiopurines, and amino acid metabolizing drugs), alkaloids and anthracyclines, in order to provide theoretical basis for coping with clinical drug resistance.

Key words: acute lymphoblastic leukemia, child, chemotherapy, drug-resistance mechanism, recurrence

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