近10余年来,通过对化疗方案的不断改进,急性淋巴细胞白血病(ALL)患者的无病生存(DFS)得到很大提高,大规模临床试验表明儿童的5年无事件生存(EFS)率高达80％,成人 ALL 的 EFS 率也可达50％～60％。儿童 ALL 初诊时约5％中枢神经系统(CNS)受累,成人 ALL 则为10％(成熟B-ALL 甚至高达12％～42％。随着完全缓解(CR)率和DFS 期的延长,髓外白血病特别是中枢神经系统白血病(CNSL)的发生率明显增加;如不进行 CNSL 的预防性治疗,约33％(29％～40％)的成人 ALL 将会发生 CNSL,儿童 ALL则高达75％以上。我们通过对大规模临床试验结果进行 In the past 10 years or more, disease-free survival (DFS) has been greatly improved in patients with acute lymphoblastic leukemia (ALL) through continuous improvement of chemotherapy regimens. Large-scale clinical trials have shown that children’s 5-year event-free survival (EFS) 80%, adult EFS EFS rate of up to 50% to 60%. Approximately 5% of children with central ALL have a central nervous system (CNS) involvement at the time of first diagnosis, 10% of adults with ALL (even up to 12% -42% of mature B-ALL.) With complete remission (CR) The incidence of leukemia, particularly CNS, is significantly increased; approximately 33% (29% -40%) of adults with CNSL develop CNSL in the absence of prophylactic treatment with CNSL and up to 75% in children with ALL We passed the results of large - scale clinical trials