Acute lymphoblastic leukemia (ALL) is a disease that affects immature lymphocytes in the blood and presents a high prevalence rate in children and adolescent young adult (AYA) populations (15–39 years). AYAs are a unique group who face a significant therapeutic disadvantage when treated with the adult regimen, as evident with lower remission rates, whereas the opposite is true in children. A recent study by EUROCARE-5 showed a marked decrease with age in 5 years relative to survival outcomes based on cancer registries of 27 European countries: 85.8% for patients 0–14 years of age and a decreased 62.2% and 52.8% for patients 15–19 and 20–39 years, respectively. There is growing evidence demonstrating that the pediatric ALL treatment regimen is effective and beneficial when treating AYAs. Treatment of ALL in AYAs around the world is showing improved remission rates with therapeutic advancements and increasing amount of data available with updated clinical trials and regimens. The addition of l-asparaginase into adult treatment regimens has significantly increased the remission rates. This administration to AYAs is more difficult but shows a positive benefit in comparison with the toxicity ratio. This review article will discuss the controversy of AYA patients diagnosed with ALL treated with pediatric or adult protocols and their perspectives in Poland and will focus on ALL etiology, epidemiology, and prognostic factors with comparison of compliance of medications between both populations of patients.

中文翻译：

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青少年和年轻人的急性淋巴细胞白血病：波兰的观点

急性淋巴细胞白血病 (ALL) 是一种影响血液中未成熟淋巴细胞的疾病，在儿童和青少年青年 (AYA) 人群（15-39 岁）中发病率很高。AYA 是一个独特的群体，他们在接受成人方案治疗时面临显着的治疗劣势，缓解率较低很明显，而儿童则相反。EUROCARE-5 最近的一项研究显示，相对于基于 27 个欧洲国家癌症登记的生存结果，5 年的年龄显着下降：0-14 岁患者为 85.8%，15 岁患者下降 62.2% 和 52.8%分别为 –19 岁和 20–39 岁。越来越多的证据表明，儿科 ALL 治疗方案在治疗 AYA 时是有效且有益的。世界各地 AYA 的 ALL 治疗显示，随着治疗的进步和更新的临床试验和治疗方案提供的数据量增加，缓解率有所提高。添加的l-天冬酰胺酶进入成人治疗方案显着提高了缓解率。这种对 AYA 的给药更困难，但与毒性比率相比显示出积极的益处。这篇综述文章将讨论在波兰接受儿科或成人方案治疗的 AYA 患者的争议及其观点，并将重点关注 ALL 的病因、流行病学和预后因素，并比较两组患者的药物依从性。