《漂亮的保姆5观看翻译中文版》现代都市,动作,女频恋爱 _成全...《漂亮的保姆》电影完整版免费观看 - 瓦力影视
再来看看内饰，嗯，是卡罗拉没错了。单从外观，我还真觉得哪有这么帅的卡罗拉，但是看到内饰我就相信了，卡罗拉无疑，这复古的内饰设计，确实有丰田的风格在里面。
2024年12月24日，趁外卖小哥急于送单
《漂亮的保姆5观看翻译中文版》现代都市,动作,女频恋爱 _成全...《漂亮的保姆》电影完整版免费观看 - 瓦力影视
一晃退休好几年了刚退休时甭提有多开心了终于不受人管制也不用小心翼翼看领导脸色和同事的态度更不用去干没完没了的工作还有那些错综复杂的人际关系
1年期贷款市场报价利率日前再度下调，意味着实体经济融资成本将随之下行。业内人士认为，当前商业银行负债端成本仍显刚性，净息差已降至近年来低位，为保持合理息差水平，商业银行存款挂牌利率可能迎来新一轮下调。专家分析，当前商业银行净息差承压状态难改，要继续推动实体融资成本稳中有降，银行负债端压力需缓解，存款利率有望再度下调。2024-07-05 17:20·海峡网
mingniabolisilianchuxingchangNeel Kashkarizhouyizaimingnisudazhoushengbaoluojuxingdetaolunhuishangbiaoshi：“meilianchuzaituidongtongzhanghuiluofangmiankenengyougengduogongzuoyaozuo”。tesilameiyoutouluzhekuandiandongpikajutideyudingdanshuliang。danjuTeslaratibaodao，genjuyigezaixianzhongbaoshujuzhuizongqi，jiezhizhouwu，Cybertruckdeyudingliangyidadao194wan3876liang。
就(闯颈耻)在(窜补颈)黄(贬耻补苍驳)晓(齿颈补辞)明(惭颈苍驳)和(贬别)础苍驳别濒补产补产测的(顿别)同(罢辞苍驳)框(碍耻补苍驳)照(窜丑补辞)片(笔颈补苍)引(驰颈苍)发(贵补)热(搁别)议(驰颈)时(厂丑颈)，一(驰颈)个(骋别)名(惭颈苍驳)叫(闯颈补辞)叶(驰别)珂(窜耻辞)的(顿别)女(狈惫)子(窜颈)突(罢耻)然(搁补苍)闯(颁丑耻补苍驳)入(搁耻)公(骋辞苍驳)众(窜丑辞苍驳)视(厂丑颈)野(驰别)。作(窜耻辞)为(奥别颈)黄(贬耻补苍驳)晓(齿颈补辞)明(惭颈苍驳)的(顿别)新(齿颈苍)女(狈惫)友(驰辞耻)，叶(驰别)珂(窜耻辞)的(顿别)出(颁丑耻)现(齿颈补苍)给(骋别颈)这(窜丑别)个(骋别)故(骋耻)事(厂丑颈)增(窜别苍驳)添(罢颈补苍)了(尝颈补辞)更(骋别苍驳)多(顿耻辞)戏(齿颈)剧(闯耻)性(齿颈苍驳)。
zhejianshilingrenzuoxu！gankaibuyi！zhegelaobansidetaiyuanliao，xingxiongzhelingrenfazhi！ertonglinbamuxibaolinbaliuzhenliaoguifan（2019 nianban）2019-10-28 16:25·zhongliujie2022yi、gaishulinbamuxibaolinbaliu(lymphoblastic lymphoma, LBL)shiyizuqiyuanyubuchengshuqianti T huo B linbaxibaodeexingzhongliu，yuezhanertongfeihuoqijinlinbaliu（Non Hodgkin Lymphoma, NHL）de 35%～40%，shiertong NHL zuichangjiandebinglileixingzhiyi。youyu LBL yujixinglinbaxibaobaixuebing（acute lymphocytic leukemia, ALL）juyouxiangsidelinchuangheshiyanshitezheng，zhexietezhengbaokuoxibaoxingtaixue、mianyibiaoxing、jiyinxing、xibaoyichuanxueyijilinchuangbiaoxianheyuhou，yincidangqian WHO fenleijiangerzhegongtongguiyuqiantilinbaxibaozhongliu，mingmingweiqianti T/B linbamuxibaobaixuebing/linbaliu（T/B-ALL/LBL）。danglinchuangyizhongliuxingbingzaoqibingerwugusuijiwaizhouxuejinrunhuogusuizhongzhongliuxinglinbamuxibaoxiaoyu25%shizhenwei LBL；dangyougusuihewaizhouxueshoulei，gusuizhonglinbamuxibaodayu 25%shi，zezhenwei ALL。anzhaomianyibiaoxingfenwei T xibaoxing（yuezhan70%～80%）he B xibaoxing（yuezhan 20%～30%）。jinnianlai，tongguocaiyongyuweixianduxiangguandeleisizhiliao ALL defanganhualiao，shiliaoxiaodedaoxianzhutigao，yixiezhiliaozhongxin 5 nianwushijianshengcunlv（Event-free survival，EFS）yidadao 75%～90%。er、shiyongfanweiyijuhuanerlinchuangtedian，jingzhongwuhuojian、xiongfushuihuogusuixibaoxingtaixue、mianyibiaoxing、xibaoyichuanxuehefenzishengwuxuejiancequezhen，bingjingzhishaoliangjiasanjijiadengyiyuanbinglizhuanjiahuizhenjieguoyizhi，an WHO 2016linbaxitongzhongliubinglizhenduanfenxingbiaozhunjinxingzhenduanhefenxingdeertongheqingshaonian LBL。san、zhenduan（yi）linchuangbiaoxian1.qianti T linbamuxibaolinbaliu（T-LBL）：qian T xibaozhongliu85%～90%biaoxianwei LBL，shaoshubiaoxianwei ALL。haofayunianchanger，zhongweifabingnianling 9-12 sui。nanxingduojian，nannvzhibi（2.5～3）:1。dianxingdelinchuangbiaoxianweiqianzongzuozhongwu，chuxianqingzhongbudengdeqidaoyapozhengzhuangrukesu、xiongmen、chuanxi、qicu、duanzuohuxideng，banxiongmoqinfankehebingxiongqiangjiye，jiazhonghuxikunnan；zongzuozhongwuyaposhiguankeyinqitunyankunnan；yaposhangqiangjingmaikezhijingmaihuiliushouzu、jingmianbuheshangzhishuizhong，ji"shangqiangjingmaizonghezheng（superior vena cava syndrome）"；qinfanxinbao，kedaozhiexingdexinbaojiyehexinbaotiansai。linbajiebingbianyuezhan 70%，yijingbu、suogushangheyexiaduojian。bufenhuanzhehebingganpizhongda。yue 50%gusuishoulei；yue 15%zhongshushenjingxitongzhuanyi，naomobingbianduoyunaoshizhibingbian；xingxianshouleiyuezhan 5%。benbingwangwangjinzhanxunsu，90%yishangbinglijiuzhenshiyichuyulinchuangⅢ、Ⅳqi。2.qianti B linbamuxibaolinbaliu(B-LBL)：yuqianti T xibaozhongliuxiangfan，qian B xibaogouchengdezhongliu 85%yishangbiaoxianwei ALL，zhiyou 10%～20%wei LBL。B-LBL fabingnianlingjiaoxiao，zhongweinianlingxiaoyu 6 sui。fabingwumingxianxingbietezheng。changjianbiaoxianweilinbajiezhongdajipifu、ruanzuzhi(youqishitoujingbu)、gu（changjianyugugu、zuogu、jizhugu）dengjiewaiqinfan，biaoxianweipifuduofaxinghongsejiejie，guneigulixingzhongkuai，yingxiangxuejianchashirongguxinghuoyinghuaxingbingbian；shaojiandebiaoxianyouzongzuo、xiongmoqinfan，neizangqinfanrushenzang、xiaohuadaojinrundeng。yeyifashenggusuihe CNS jinrun。（er）shiyanshijiancha1.binglijiancha：suoyoubingrenjunxutongguozhongliuzuzhihuogusuibinglihuojianquezhen。（1）binglixingtaixue：linbajiejiegoupohuai，zhongliuchangqinfanlinbajiebaomo、jiewaizhifanghexianweizuzhi。liuxibaochengmimanxingzhimidexiangduidanyixingjinrunshengchang，xibaozhongdengdaxiao，hezhibigao，heyuanxing、luanyuanxinghuoquxinghe，ransezhixirufenchen，herenchangbumingxian，baozhixishaodanran，hefenliexiangduojian。xibaoxuetezhengyu FAB fenxingzhongde L1 huo L2 xingyouzhilinbaxibaoxiangduiying。liuxibaojianhenshaoyouqitafanyingxingxibaochengfen，bufenbinglikejian"xingkongxianxiang"。（2）mianyibiaoxing：①linbamuxibaodebiaozhi：baokuo TdT、CD99、CD34、CD1a。LBL laiyuanyuqiantide T huo B linbaxibao，TdT beirenweishiqiantilinbaxibaodetezhengxingbiaozhi，xiongxianhuogusuiqian T、qian B xibaojunkechengxianyangxingbiaoda，wenxianbaodaoqiyangxinglvkeda 90%～95%。CD99 yebeirenweishiqianT xibaodelianghaobiaojiwu，dantabujinbiaodayurendexiongxianpizhixibaoyiji ALL/LBL xibaozhong，zai Ewing's rouliu（ES）、yuanshishenjingwaipeiyezhongliu（PNET）yijixiongxianliuzhongyejunyouyangxingbiaoda，yincizaijianbiezhenduanshangbixupeiyixiangyingdeqitayouxiaobiaozhilianheguancha。②T-LBL fashengyuxiongxianzuzhi，zhongliuxibaolaiyuanyuqianxiongxianxibao、xiongxianxibao，biaoda CD3、CD2、CD5、CD7，CD7 shiqiteyixingkangyuan。muqianrenwei T-LBL laiyuanyuxiongxianzhongfayuxiangduichengshudeqianti T xibao，er T-ALL jiaozhiyougengzaoqidefenhuajieduan。COG baogaoliao 180 li T-LBLdemianyibiaoxingtezhengyu T-ALL xiangsi，dan CD4/CD8 shuangyangxingdefashenglvmingxiangaoyuhouzhe，yezhichi T-LBL juyougengchengshumianyibiaoxing。③B-LBL zhongliuxibaolaiyuanyugusui，shuyuqianqian B、qian B、putongB jieduan，biaoda CD10、CD19、CD20、CD22、CD79a，qizhong CD79awei B xibaoteyixingkangyuan。Mayer dengbaodao 22%B-LBL cunzaimianyiqiudanbaiγqingliandequeshi，erzai B-ALL zhongdefashenglvjinwei 1%，yetishiliaoB-LBL laiyuanyujiao B-ALL shaochengshujieduandeqianti B xibao。④zaoqian T linbaxibaobaixuebing/linbaliu（ETP-ALL/LBL）：qiyuanyuzuichufenhuajieduandexiongxianxibao，juyouxiang T xi、suixi、shutuzhuangxibao、NK xibaofenhuadeqianneng，mianyifenxingtedian：quefa CD1a、CD4、CD8 debiaoda；CD5 ruobiaodahuozhebubiaoda；zhishaoyouyigesuixihuoganxibaoxiangguandekangyuanbiaoda（CD13、CD33、CD117、CD11b、CD34、HLA-DRdeng）；biaoda CD7、CD2、CD3 deng T xibaobiaozhi。yuezhan T-ALL/LBLde 10%～15%。benxingyuhoujiaocha。2.xibaoyichuanxue（Cytogenetics）hefenzishengwuxue（Molecular biology）benbingyuduozhongjiyinyichangyouguan，baokuokangyuanshoutijiyin、ransetiyichang、yiaijiyinshihuoyijiaijiyindejihuodeng。tongguoransetihexingfenxi、FISH fangfa、ronghejiyindingliang RT-PCR、IgH/TCR zhongpaijiance、xinyidaicexu（NGS）defangfajinxingxiangguanjiancha。95%yishang T-ALL/LBL you T xibaoshouti(T cell receptor,TCR)jiyinkelongxingzhongpai，daduoshu T-ALL biaoxianweifenhuachengshuguochengzhongshouxianzhongpaide TCRγσlianjiyin，er T-LBL zeduoweiαβlianjiyinzhongpai，yetishiliao T-ALL defenhuajieduanzaoyu T-LBL。dayue 20％T-ALL/LBL tongshiyou IgH jiyinzhongpai。juedaduoshu B-LBL you Ig-H jiyinzhongpai，yekeyou Ig-L jiyinzhongpai。50％～70％de T-ALL/LBL youransetihexingyichang。daduoshuhexingyichangyufeisuijixingduandianyouguan：changleiji TCRασ（14q11.2），β（7q35），γ（7q14-15），baokuocharutubian、queshiyijiransetiyiwei。yiweitongchangshiyuanaijiyinjihuobingyichangbiaoda，daozhiyuxibaozhouqidiaokonghexibaofenhuaxiangguandebajiyinjihuoerzhizhongliu。xianyizhiyuT-ALL/LBL fabingyouguandezhongyaoyuanaijiyinyou T xibaojixingbaixuebingjiyin 1(TAL-1)/SCL、HOX11、HOX11L2、LYL1、LMO1 he LMO2 deng。del（9p）queshidaozhideyiaijiyin CDKN2A dediushiyeshibenbingfashengdejizhizhiyi。muqianyizhijuyoujihuotubianleijibianmaqian T xibaofayudeguanjiandanbaideNOTCH1jiyindebingrenyuhoulianghao，fashenglvyuewei50%；eryue 10%debingrenjuyouranseti 6q zahexingqueshi（Loss of heterozygosity at chromosome 6q；LOH6q），qifufafengxianzenggao，yuhoubuliang。yue 60% B-ALL/LBL youtezhengxingyichuanxuegaibianqiejuyouzhongyaodelinchuangzhenduanheyuhoupanduanyiyi。yichuanxueshangtishiyuhoujiaohaodeyouchaoerbeiti(ransetishu＞50)hexingji t(12;21)(p12;q22）yiweixingchengTEL/AML1 ronghejiyin；eryaerbeiti(ransetishuxiaoyu 45)、t（9;22）(q34;q11.2)xingcheng BCR/ABLl、 t（ 4;11 ）huo MLL/AF4 、 t（1;19)(q23;13.3)xingchengde(E2A-PBX1; TCF3/PBX1)yiji Phyangjiyinhuotubiandengyulinchuangliaoxiaobujia、yuhoubuliangxiangguan。3.xuechanggui：baixibaokezhengchanghuoqingdushenggao，keyoupinxue，duoweizhengxibaozhengsesuxingpinxue。danggusuishouleishi，keyoubaixibaozongshushenggaohuojiandi，waizhouxuechuxianyouzhixibao，kebanyoupinxuehe/huoxuexiaobanjiandi。4.xueshenghua：ganshengongneng、rusuantuoqingmei（LDH）、dianjiezhishibichaxiangmu。wangwangbiaoxianweiniaosuan、rusuantuoqingmeizenggao，zheliangxiangzhibiaoduijibinghuanjieqingkuangjiyuhouyoutishizuoyong。5.ningxuegongneng：baokuo PT、APTT、TT、FIB、D erjuti、FDP。benbingkezaochengningxuegongnengyichang，ningxuemeiyuanhexianweidanbaiyuanjianshao，congerdaozhiningxuemeiyuanshijianyanchanghechuxue。6.gusuijiancha：gusuishouleishi，gusuizhongyouzhilinbaxibaoyibanxiaoyu 25%，tongguoliushixibaoshu、xibaoyichuanxue、jiyinzhongpaidengjianchayouzhuyuzhenduanhefenxing。liushixibaoyijiancekeyifaxianyinxingdegusuishoulei。gusuihuojianduigusuiqinfandejianchulvgaoyugusuixingtaixue。7.naojiyejiancha：changguixingnaojiyechanggui、shenghua、shuaipianzhaozhongliuxibaoliaojieyouwuzhongshushenjingxitong（Central nervous system, CNS）deqinfan。liushixibaoyijiancezhongliuxibaomianyifenxingketigao CNS qinfanjianchulv。8.yingxiangxuejiancha：zhiliaoqianxuchangguijinxingquanshenyingxiangxuejianchayimingqueshouleibuwei，xiezhufenqi。X xianjiancha：gupian（yougu、guanjiezhongtongzhe）；B chao：zhishaobaokuojingbulinbajie B chao、fubu B chaojibingzaobuweixiangguan B chao（zuozuidaliuzaoceliang）；CT：zhishaobaokuoxiongfupen CT pingsao（ruozuo PET/CT，kebuzuochanggui CT jiancha，jinzuobingzaobuweijiancha）；bingzaobuweixuxingzengqiang CT jiancha；huaiyizhongshushenjingxitongbingbiandexingtouluhe（huo）jisui MRI jiancha；youtiaojianzhejinkenengxingquanshen PET/CT jiancha。（san）ertong LBL dezhenduanbiaozhun1.zhenduanbiaozhunWHO 2016youguanlinbazaoxuezuzhizhongliufenleizhongguidingliaoLBLdezhenduanbiaozhun。chuyijuhuanzhelinchuangtedianwai，junxujingguoshouleizuzhihuojian，jinxingzuzhibinglixue、mianyibiaoxing、xibaoyichuanxuehefenzishengwuxuedejiancequezhen。linchuangfenqi：genjuquanshenyingxiangxue、naojiyejigusuidengjiancha，yiwanganzhaoSt Judefenqixitongquedingfenqi（jianfubiao1）。suizhuoyixuefazhan，ertongNHLxindebingliyaxingdezengjia，xibaoyichuanxue、fenzishengwuxuehemianyibiaoxingfangmiandejinbu，xindezhenduanfangfazaijianceweixiaokuosanbingzaohuoweixiaocanliubingzaodelinchuangyingyongyijiyingxiangxuefangmiandezhongyaojinzhan，zaiyuanyouSt Jude fenqixitongshangjinxingliaobuchonghegailiang，chanshengliaoxindefenqixitong：xiudingguojiertongNHLfenqixitong(IPNHLSS)，jinyibumingquehebuchongliaomeiyiqidedingyi，bingjiangzuixindeyixuejinzhanxinxijiaruliaofenqixitong（jianfubiao2）。2.gusuiqinfandezhenduan：xuyaoxinglianggebuweigusuichuancihezhishaoyigebuweigusuihuojianjinxingfenxidingyigusuiqinfan。（1）gusuichuancixibaoxingtaixue：gusuiyouzhixibaohuolinbaliuxibao≥5％。（2）gusuimianyibiaoxingfangfa(mianyizuzhihuaxuehuoliushixibaoshufenxi：tezhilinbaliuxibaobaifenbi)yangxing。（3）gusuixibaoyichuanxuehuoFISHfenxiyangxing。（4）gusuiPCRfangfajiancefenzishengwuxueyangxing。（5）gusuihuojiankeyijiandaozhongliuxibaojinrun。3.zhongshushenjingxitongqinfandezhenduan：naojiyezhuangtaifenjizhuyaoyijulinchuangbiaoxian、yingxiangxuegaibian、naojiyejiancha。（1） CNS1：tongshifuheyixiasantiao：①naojiyezhongwuzhongliuxibao；②wuzhongshushenjingxitongyichangdelinchuangbiaoxian；③wuzhongshushenjingxitongyichangdeyingxiangxue（CT/MRI）yiju。（2） CNS2：fuheyixiarenheyitiao：①yaochuanwusunshang—naojiyebuhunxue（hongxibao:baixibao≤100:1）shi，naojiyebaixibaojishu≤5/μl，bingjiandaomingquedezhongliuxibao；②yaochuanyousunshang—naojiyehunxue（hongxibao:baixibao＞100:1）shi，naojiyejiandaomingquedezhongliuxibao；③yaochuanyousunshangbingweixuexingnaojiye，bulunyouwuzhongliuxibao，ruchuzhenbaixibaoshu＞50×109/L zeguiwei CNS2；④zhongshulinjinbuweideqinfanweifasheng CNS qinfandeweixianyinsu，weiliaojiaqiangyufangguiwei CNS2：toumianbupifu、ruanzuzhihuoguzuoqinfan，rulugu、bizuo、yankuangdeng（weitupoyingnaomo）；jizhugupohuaihuozhuipangqinfanbubanshenjingxitongzhengzhuangde，wu CNS zhanwei、naojiyejianchazhengchang。（3）CNS3：fuheyixiarenheyitiaowei CNS qinfan：①naojiyebaixibaojishu＞5/μl，bingyizhongliuxibaoweizhu，tongshihongxibao:baixibao≤100:1；huozhenaojiyebaixibaojishu＞5/μl，qizhongzhongliuxibaosuozhanbiligaoyuwaizhouxueyouzhixibaobaifenbi；②lushenjingmabi，jishinaojiyezhongwuzhongliuxibao、lunao MRI/CT weifaxianzhanweixingbingbian；③CT/MRI kejiannao、jisuihuonaomo、jimobingbian。④jizhugupohuaihuozhuipangqinfanyinqipainiaoyichang、zhitihuodongzhangaidengshenjingxitongzhengzhuang。4.zuowanqinfandezhenduan：huanerbiaoxianweizuowandancehuoshuangcezhongda，zhidibianyinghuochengjiejiezhuangquefadanxinggan，touguangshiyanyinxing，B chaojianchakefaxianzuowanchengfeijunzhixingjinrunzao，chuzhenhuanerkebuyuhuojian。zaiquanshenhualiaohuanjiedehuanerchuxianzuowanzhongdazhe，yingjinxinghuojianyiquedingshifouzuowanfufa。（si）jianbiezhenduan1.jixingsuixibaixuebinghelixibaorouliu：xingtaixueshangchengsuixibaoyuLBL delinbamuxibaonanyiqubie。danchengsuixibaoxingtaijiaobuyizhi，xibaozhijiaoduo，baozhineikejianhongranbangzhuang Auer shixiaoti。mianyibiaoxing MPO、CD13、CD14、CD15 he CD64 chengyangxingfanying；TdT yiji T huo B linbaxibaobiaozhiweiyinxing。2.Burkitt's linbaliu：xingtaixueshangerzheyouxiangsizhichu，junweizhongdengdaxiaodedanxingxingzhongliuxibaogoucheng，dukechuxian"xingkongxianxiang"。danLBL oujianzaoxing"xingkongxianxiang"，er Burkitt's linbaliu"xingkongxianxiang"changchangguanchuanyuzhenggeliuzuzhi。liuxibaobiaoda sIgM、CD10、EBER1/2 yuanweizajiaoyangxing。xibaoyichuanxuexianshiyoutezhengxing t（8;14）（q23;q21)huo c-myc jiyinzhongpai。3.feilinbazaoxuexitongxiaoxibaoxingexingzhongliu：zhuyaobaokuoyouwenshirouliu、yuanshishenjingwaipeiyezhongliu、shenjingmuxibaoliu、xiaoxibaoweifenhuaaideng。youqishifashengyulinbajiewaidexiaoyuanxibaozhongliu，youyuqimuxibaohuatezheng，qieertongyiweihaofanianlingzu，yincidang CD99（+），er LCA、CD3、CD20 junyinxingshiyiwuzhenweicileijibing。kexuanyongduozhongkangyuan，baokuoshenjingneifenmibiaojiwu（CgA、Syn）dengkezijianbie。4.xiongxianliu：yibanweiyuqianshangzongge，jishaofashengyuertongjiqingshaonian。congbinglishangliangzhejunbiaoxianweilinbaxibaomimanxingshengchang，TdT junchengyangxing。xiongxianliuliuzuzhichengfenyezhuang，jianmingxiandexianweibaomojicudadexianweijiange；sanzaidedifenzizhiliangjiaodanbai（CK）yangxingxibaoguanchuanyuzhenggeliuzuzhi。er LBL zhong，youyuliuxibaodejinrunxingshengchang，zaicancundexiongxianzuzhizhongkechuxianshaoliangzaoxingfenbude CK yangxingxibao。5.jitailiu：zonggeneikenengfashengliangxingheexingjitailiu，yeduofashengyuqianzongge，zhongliuneihanyougaomidudewuzhirugaihuaruangu、gu、chidengzuzhishi，X xianjianchachangkequedingzhenduan；xuezhongjiataidanbaizenggaozheduoweiexing。6.qitazonggezhongliu：rushenjingyuanxingzhongliu、xianweiliu、zhifangliu、linbaguanliudeng，junxutongguolinchuangbiaoxian、zhongliuzaizonggezhongdeweizhi、yingxiangxuetedianjibinglijianchajinxingjianbie。（wu）linchuangzhiliaofanyingpinggubiaozhun、pinggushijiandianjineirong1. pinggubiaozhun（1）liuzaohuanjieqingkuang①wanquanhuanjie（CR）：tongguochatiheyingxiangxuejianchazhengshisuoyouliuzaoquanbuxiaoshi。CT xianshiyuanzhongdadelinbajiehezhongkuaiyisuoxiaozhizhengchangfanwei（zuidajingxian＜ 1.5 cm），geqiguanyingxiangxuekejiandaodesuoyouliuzaojunyixiaoshi。PET saomiaoyiwuyangxingfaxian。gusuitupian/huojianzhengchang；liushixibaoshujinxing MRD jianceweiyinxing。②weiquedingdewanquanhuanjie（Unconfirmed complete response）：suiranbingzaozuidajing＞1.5cm，danzongtishangbingzaosuoxiao＞75%（xianghuchuizhiliangtiaozuidahengjing）。congyingxiangxueshangwufaquedingshifouweicanliudezhongliuxingbingzao，yingxingbinglihuojianqueding，eryoudebingzaoyoukenengbushiyushoushuhuojianqueding。③bufenhuanjie (PR)：liuzaozuidajingxiansuoxiao≥ 50% ，meiyouxinfaliuzao。④wufanying(NR)(jibingwending)：pingguxianshimeiyoudadao PR， danyemeiyouxinfaliuzao。⑤jibingjinzhan (PD)：renheliuzaozengda≥ 25% huochuxianxinfaliuzaohuogusuifufa。（2）fenzishengwuxuehuanjie（MCR）：jiancefenzishengwuxuebiaoji，lirutongguo PCR fangfajiancegusuironghejiyincongyangxingzhuanweiyinxing。（3）fenzishengwuxuefufa（huoyinzhuanyang）：ruyoufenzishengwuxuebiaoji，zhiliaohouzhuanweiyinxingdejiyinhuoqitaronghejiyinzaicijianceweiyangxing。2.hualiaoqijianpinggushijiandian（1）qiangdesongyuzhiliao d8：pingguwaizhouxueyouzhixibaoshujizhuyaoliuzao；（2）VDLPfanganyoudaozhiliao d15jinzuogusuichangguiji MRDpinggu；（3）VDLP fanganyoudaozhiliao d33；（4）CAM2 fanganhualiaohou：chengweizhongqipinggu；（5）yanchiqianghuaⅠkaishiqian；（6）yanchiqianghuaⅡkaishiqian；（7）weichizhiliaoqijian：weichizhiliaokaishishi：baokuozhongjianweichijidaweichikaishiqian；weichizhiliaoqiansigexunhuanmei 8 zhoupingguyici（baokuogusuijianchajiliuzaopinggu），yihoumei 8 zhouxiaopingguyici（jiandanyingxiangxuejiancha，wuguchuanheyaochuan），mei 16 zhoudapinggu 1 ci（baokuonaojiyehegusuijiancha）。3.hualiaoguochengzhongpingguneirong（1）qiangdesongyuzhiliao d8：jinxingwaizhouxueyouzhixibaopinggujizhuyaoliuzaopinggu，yizuozhuyaoliuzaode B chaojianchaweizhu，zongzuozhanweikexingCT jiancha，bingxingzhongliujingxianceliang，zhongliuhuisuodayu 25%、waizhouxueyouzhixibaoxiaoyu 1000/mm3weiduiqiangdesongmingan；（2）VDLP fangan d15：yougusuiqinfandebingrenfuchagusuixingtai，bingtongguoliushixibaoyijiancegusui MRD；（3）qitashijiandianpinggu：baokuo①gusuihuanjieqingkuang：gusuixingtaiheliushixibaoyijiancegusui MRD；gusuironghejiyinyangxingzhexufuchagusuijiyinzhuanyin。②liuzaoqingkuang：liuzaobuweixiangguanyingxiangxuejiancha。si、linchuangweixiandufencengLBL weixiandufencengshangwutongyibiaozhun，yuanzeshangshizonghelinchuangfenqi、zhongliuxibaoyichuanxuetezhengyijizhiliaofanyingdengjiayiqueding。zaizhiliaozaoqixugenjuweixianyinsu，quedingweixiandufenzuweidiweizu、zhongweizu、gaoweizu。（yi）diweizuanzhaoxiudingdeguojiertong NHL fenqixitong，bujuyougaoweiyinsudeⅠ、Ⅱqibingren（cunzaizaoqizhongliuzifarongjiehuojudaliukuaideⅡqibingrenchuwai）。（er）zhongweizubujuyougaoweiyinsudeⅢ、Ⅳqibingren。（san）gaoweizuxutongguoliuzao、gusui、waizhouxuepingguliaojiezhiliaofanying。1.qiangdesongyuzhiliao d8，waizhouxueyouzhixibaodayu 1000/mm3。2.youdaozhiliao d15 gusuiyouzhixibao＞25%。3.youdaozhiliao d33 zhongliucancun＞25%huogusuiyouzhixibao＞5%；gusui MRD≥10-2；naojiyezhongchixucunzaiyouzhixibao（zhisanciqiaozhuhounaojiyezhongrengyouzhongliuxibao）。qizhongrenyixiang。4.gongguzhiliaoqian（CAM2 hualiaohou）pinggurengyoucanliubingzaozhejinliangxinghuojian，rengweizhongliuzuzhi（ruguomeiyoutiaojianzuoercihuojiankeshitiaojianxing PET／CT xiezhujianbie）；gusui MRD≥10-3。qizhongrenyixiang。5.juyoubuliangyichuanxuetezheng：t(9;22)huo BCR/ABL，t(4;11)huoMLL/AF4jiqitaMLLjiyinzhongpai、PhyangALLxiangguanjiyinruIKZF1、CRLF2、JAK2 deng。wu、zhiliao（yi）xitonghualiao1.hualiaoyuanze：jiyu LBL shengwuxuetexingleisiyu ALL，jinnianlaiguojishangcaiyongleisi ALL dehualiaofanganhouxianzhugaishanliaoyuhou，bijiaoguojijingdianfangan，yi BFM90 liaoxiaozuijia，benjianyitigongdezhiliaofanganshiyi BFM90 weijichudegailiangfangan，geyiyuankegenjugeziqingkuangxuanzeyingyong。yunxuduisuocaiyongdefanganjinxingweidiao，quyuzhongxinhuodadeyiliaozhongxinkezaiyuanzebubiandejichushangtichuhelixiugai。2.hualiaoqianzhunbei（1）quezhenjiancha：jinkenengzaizuirongyiqucaidebuweiqudebiaobenxunzhaozhongliuxibao，baokuo：gusui、xiongfushui、qianbiaolinbajie、pifukeyiliuzao、shenbulinbajiechuancihuohuojian、xiongfuqiangliuzaochuancihuoshoushuquhuojian。ranhouwanshanzhongliuxibaode MICM fenxing；wanchengzhongxinbinglihuizhen（zhishaoliangjiasanjiayiyuanbinglizhuanjiahuizhen）。（2）jianyixionggujizuogulianggebuweigusuichuancihuohuojian：yingxinggusuixibaoxingtaixue、liushixibaomianyibiaoxingfenxi、xibaoyichuanxuehejiyinjiancha。（3）changguijiancha：baokuoquanxuexibaofenxi、baixibaofenlei、ganshengongneng、xueqingrusuantuoqingmei、xiongfushuijiqitatiyedexibaoxuejianchadeng。（4）naojiyejiancha：xibaolixinfazhaoliuxibao、liushifangfajianceweiliangxibao。（5）yingxiangxuejianchajinxingfenqi：xingkeyilinbajiejifubu B chao、keyishouqinbuweideguzuopian、CT dengyingxiangxuejianchayibianliaojiebingbianfanwei。huaiyizhongshushenjingxitongbingbianshikexingnaojijisuicigongzhen（MRI）jiancha。youtiaojiandexing PET/CT jiancha。（6）hualiaoqianjiancha：liaojiezangqigongneng、mianyizhuangkuang、bingduganran、chuanranbingdengzhuangkuang。3.changguihualiao：yi BFM90 weijichudezhiliaofanganbaokuo VDLP+CAMyoudaohuanjiezhiliao、4 liaocheng HD-MTX（jiaandiezuo）huo 6 liaochenggaoweifangandehuanjiehougongguzhiliao、VDLD+CAM yanchiqianghuazhiliao、6-MP+MTXdeweichizhiliaodenghuanjie。butongyu ALL，LBL zhongⅠ、ⅡqihuanzhewuyanchiqianghuaⅡzhiliao，yanchiqianghuaⅠzhiliaohouzhijiejinruweichizhiliao。yuqitaleixing NHL butong，LBL zaidadaowanquanhuanjiehou，huanxujinxingweichizhiliao，qimudeshiyoudaozhongliuxibaofenhua、diaowang，dadaochediqingchucanliubingzaodemude。zongliaochengyuewei 24 geyue。zhiliaoguochengzhongxudingqijinxingpinggu，baokuogusuichanggui、gusui MRD dejiancejiliuzaodepinggu，liaojiehuanjiezhuangtai，jishidiaozhengzhiliaofangan。4.zhongshushenjingxitongjinrundeyufangjizhiliao：yuanzeshangquchuliaolunaofangliao（baokuo CNS3 bingren），yijiaqianghualiao、zengjiaqiaozhujiaqiang CNS qinfandeyufanghezhiliao。（1）CNS1 dezhiliao：suoyoubingrenjunjieshouyufangxingsanlianqiaozhuji 4liaochengdajiliang MTX hualiao，qizhong T-LBL 5 g/m2；B-LBL 3 g/m2。zhenggehualiaoguochengzhong，B-LBL zhishao IT 20 ci，T-LBL 22 ci。（2）CNS2 dezhiliao：zaiyoudaohuanjie VDLP fanganzhong（di 8、22tian）zengjia 2 cisanlianqiaozhu，jimeizhouyici，gong 5 ci。quanchenggong 22～24 ci。（3）CNS3 dezhiliao：zaiyoudaohuanjie VDLP fanganzhong（di 8、22tian）zengjia2cisanlianqiaozhu，jimeizhou1ci，gong5ci。yanchiqianghuaⅠ VDLD（di 1、15 tian）zengjia 2 ciqiaozhu。quanchenggong 26～30 ci。（4）weichizhiliaoqijiande CNS zhiliao：CNS2（baokuozhongshulinjinbuweiqinfanzhe）、CNS3 bingrenweichizhiliaoqijianzengjialiangciqiaozhu。T-LBLweichizhiliaoqijianmei 4 zhouqiaozhu 1 ci，gong 12 ci；B-LBL mei 8 zhouqiaozhu1 ci，gong 8 ci。zhu：annianlingsanlianqiaozhujiliang（jianfubiao 3）。5.zuowanjinrundezhiliaoyuanze（1）dangzhenduanshicunzaizuowanwutongxingzhongdadengdianxingzuowanjinrundezhengzhuangshi，buyidingbixuxinghuojian，ketongguo B chaoquezhen。ruojingguoyoudaojigongguzhiliaohouzuowanzhongwuxiaoshi，B chaojianchazuowanshizhihuishenghuifuzhengchangkebufangliao。（2）ruojingguoyoudaojigongguzhiliaohourengyouchixucunzaidezuowanzhongwu，xuxinghuojian。jingbinglizhengshirengcunzaizuowanjinrunzhe，yugongguzhiliaoM houxuxingshuangcezuowanfangliao，jiliangwei 18-24Gy。（er）hualiaofangan1.chushiyoudaohualiaofangan：VDLP fangan+liangliaocheng CAM fangan。（1）VDLP fanganyoudaozhiliao：changchunxinjian（VCR）1.5 mg/(m2·d)，meizhou 1 ci，gong 4 ci，meicizuidajueduiliangbuchaoguo 2 mg，d8、d15、d22、d29，gong 4 ci；rouhongmeisu（DNR）25 mg/(m2·d)，jingmaidizhu 6 xiaoshiru，meizhou 1 ci，d8、d15、d22、d29，gong 4 ci；zuoxuanmendongzuoanmei（L-Asp）5000 u/(m2·d)，d8、d11、d14、d17、d20、d23、d26、d29，Q2d，gong 8 ci，jirouzhushe；ruo L- ASP guominkeyupeimendongmei（PEG-ASP）2500 IU/m2，jirouzhushe，d9，d23，gong 2 ji；ponisong（PDN）60 mg/(m2·d)，d1～d28，koufu，di 29～35 tiandijianzhiting。PDN duiyuzhongliufuhedadehuanzheqishijiliang[(0.2～ 0.5mg/(kg·d)]kaishiyizhouneizhujianzengzhi 60mg/(m2·d)，yimianfashengzhongliurongjiezonghezheng。danlian MTX qiaozhu，d1；sanlianqiaozhu（TIT），CNS1：d15、d33；CNS2、CNS3：d8、d15、d22、d33。（2）CAM fangan：ruohuanerwufare、wuyanzhongganran；ANC≥0.5×109/L，PLT≥50×109/L shi，keyu d36 kaishidiyilun CAM fangan。gong 2 geliaocheng CAM fangan，jutiyaowujianxia：huanlinzuoan（CTX）1000 mg/(m2·d)，1 ci，d1，shuihuajianhua 3 tian；meisina 400mg/(m2·ci)，yujingmaidizhu CTX de 0h、4h、8h，d1；atangbaozuo（Ara-C）75 mg/(m2·d) ，d3～d6，d10～d13,gong 8 tian；6-zuojizuozuo（6-MP）60 mg/(m2·d)，gong 14 tian。sanlianqiaozhu，d10。xiuliao 1-2 zhou；ANC≥0.5×109/L，PLT≥50×109/L；wufarejiyanzhongganran；kaishidi 2 lun CAM。2.huanjiehougongguzhiliao（1）diweizuhezhongweizugongguzhiliao M fangan：CAM2 jieshuhou 1-2 zhou，wufare、wuyanzhongganran；jizuoqingchulvzhizhengchang；gangongneng ALT/AST≤10 beizhengchangshangxianzhi；danhongsu≤3 beizhengchangshangxianzhi，ANC≥0.5×109/L，PLT≥50×109/L shikeyikaishigongguzhiliaofangan M。CAM2 houxuexianghuishengjifuchaguchuan，bingxingliuzaopinggu，weijianmingquecanliubingzao，keyikaishi M fanganhualiao。jutiyaowuruxia：dajiliangjiaanzuozuo（MTX）3～5 g/(m2·d),meiliangzhou 1 ci，gong 4 ci[T-LBL:5 g/(m2·ci)；B-LBL:3g/(m2·ci)]，d8、d22、d36、d50；siqingyesuangai（CF）15 mg/m2，6 xiaoshi 1 ci，3～8 ci，genju MTX xueyaonongdugeiyudiaozheng。6-MP 25 mg/(m2· d)，buchaoguo 56 tian，genju WBC diaozhengjiliang。sanlianqiaozhu：d8、d22、d36、d50。yingyongdajiliang MTX qijianxuyaojinxingshuihua、jianhua，bingjiance MTXxueyaonongdu。45 xiaoshicha MTX nongduxiaoyu 0.25μmol/L weizhengchang。ruoMTX gaoyuzhengchang，genjunongdudiaozheng CF yonglianghecishu（jianfubiao 4）。（2）gaoweizugongguzhiliaofangan：CAM2 houxuexianghuishengjifuchaguchuan，bingxingliuzaopinggu，anzhaoweixiandufenzujinrugaoweizubingrenkeyijinrugongguzhiliaogaowei（HR）fanganhualiao。CAM2 jieshuhou 1～2 zhou，wufare、wuyanzhongganran；jizuoqingchulvzhizhengchang；gangongneng ALT/AST≤10 beizhengchangshangxianzhi；danhongsu≤3beizhengchangshangxianzhi；ANC≥1×109/L，PLT≥100×109/L shikeyikaishi HR fangan，shuncibaokuo HR-1、HR-2、HR-3 fangan。① HR-1 fangan：DXM 20mg/(m2·d)，koufuhuojingmaituizhu，d1～d5；VCR 1.5 mg/m2/ci（zuida 2 mg），jingmaituizhu，d1，d6；HD-MTX 5 g/(m2·ci)，jingmaidizhu，d1；CF 15 mg/(m2·ci)，6 xiaoshi 1 ci，3～8 ci，genju MTX xueyaonongdudiaozheng；CTX 200 mg/(m2·ci)，12 xiaoshi 1 ci，jingmaidizhu，d2～d4，gong 5 ci，HD-MTX jieshuhou 7h kaishiyu；meisina 70 mg/(m2·ci)，yujingmaidizhu CTX de 0h、4h、8h；Ara-c 2000 mg/(m2·ci)， 12 xiaoshi 1 ci，d5，gong 2 ci；L-ASP 25000 u/(m2·d)jingmaidizhu 2 xiaoshiyishang，d6、d11；ruguo L-ASP guomin PEG-ASP 2500 u/(m2·ci)，jirouzhushe，d6；TIT d1。② HR-2 fangan：DXM 20 mg/(m2·d)，koufuhuojingmaituizhu，d1～d5；changchundixin（VDS）3 mg/(m2·ci)，jingmaituizhu，d1，d6；HD-MTX 5 g/m2/ci，jingmaidizhu，d1；CF 15mg/(m2·ci)，6 xiaoshi 1 ci，3～8 ci，genju MTX xueyaonongdudiaozheng；yihuanlinzuoan（IFO）800 mg/(m2·ci)，jingmaidizhu，12 xiaoshi 1 ci，d2～d4，gong 5 ci，HD-MTX jieshuhou 7h kaishiyu；meisina 300 mg/(m2·ci)，jingmaidizhu，IFO 0h、4h、8h；DNR 30 mg/(m2·ci)，jingmaidizhu，d5；L-ASP 25000 u/(m2·ci)，jingmaidizhu 2 xiaoshiyishang，d6、d11；ruguo L-ASP guomin PEG-ASP 2500 u /(m2·ci)，jirouzhushe，d6；TIT d1。③ HR-3 fangan：DXM 20 mg/(m2· d)，koufuhuojingmaituizhu，d1～d5；Ara-c 2000 mg/(m2·ci)，jingmaidizhu，12 xiaoshi 1 ci，d1～d2；yituobozuo（VP-16）100 mg/(m2·ci)，jingmaidizhu，12 xiaoshi 1 ci，gong 5 ci，d3～d5；L-ASP 25000 u/(m2·ci)，jingmaidizhu 2 xiaoshiyishang，d6、d11；ruguo L-ASP guomin PEG-ASP 2500 u/(m2·ci)，jirouzhushe，d6；TIT d5。3 liaocheng HR fanganhouxinggusuiheliuzaopinggu，CR debingrenzhihouzaizhongfu HR-1、HR-2、HR-3 fangan，jiyu MTX nongdujiancedesiqingyesuanjiejiujianfujian 3。ruguoyouliuzaojinzhanhuochuxianxinfaliuzaoxuchuzu，gaiyongerxianfanganzhiliao。3.yanchiqianghua I zhiliao（1）VDLD fangan：danggonggufanganjieshuhouyue 2 zhou，wufare、wuyanzhongganran；ANC≥1×109/L，PLT≥100×109/L shikekaishicifanganhualiao。benliaochenghualiaoqianfuchagusui，bingxingliuzaopinggu。jutiyaowuruxia：VCR 1.5 mg/(m2· d)，meizhou 1 ci，diweizuhezhongweizugong 3ci，D1、8、15；gaoweizugong 4 ci，d1、d8、d15、d22，meicizuidajueduiliangbuchaoguo 2 mg；DNR huoameisu（ADR）25 mg/(m2· d)，meizhou 1 ci，diweizuhezhongweizugong 3 ci，d1、d8、d15；gaoweizugong 4 ci，d1、d8、d15、d22；L-asp 10000 u/(m2·d)，jirouzhushe，Q2d，d1、d4、d7、d10，gong 4 ci；L-ASP guominkeyupeimendongmei（PEG-ASP）2500 IU/(m2· ci)，jirouzhushe，d4，gong 1 ji。DXM 8～10mg/(m2· d)，d1～d7，d15～d21；sanlianqiaozhu：d1、d15（jin CNS3 zhezengjia 2 ci IT）。(2)CAM fangan: xiuliao 1～2 zhou；ANC≥1×109/L，PLT≥100×109/L；wufarejiyanzhongganran；jizuozhizhengchang；kaishi CAM fanganhualiao。jutiyaowuruxia：huanlinzuoan（CTX）1000 mg/(m2· d)，1 ci，d1，shuihuajianhua 3 tian；meisina 400 mg/(m2·ci)，yujingmaidizhu CTX de 0h、4h、8h，d1；atangbaozuo（Ara-C）75 mg/(m2· d)，d3～d6，d10～d13,gong 8 tian；6-zuojizuozuo（6-MP）60 mg/(m2· d)，gong 14 tian。sanlianqiaozhu，d3。xiuliaoyue 2 zhou，wufarejiyanzhongganran；ANC≥0.2×109/L，PLT≥50×109/L；kekaishiweichizhiliao。4.zhongjianweichizhiliao。zhongweizubingrenwanchengyanchiqianghuaＩhoujinru 8zhouzhongjianweichizhiliao（jiyong 8 zhou 6-MP+MTX/VD fangan，jutifanganwei：6-MP 50 mg/(m2·d)，chixushuiqiankongfukoufugong 8zhou；MTX 20 mg/m2，meizhou 1 ci，gong 8 ci，koufuhuojirouzhushe，genju WBC diaozhengfanganzhong6-MP dejiliang。VCR 1.5 mg/(m2· d)，1 ci，d1，meicizuidajueduiliangbuchaoguo 2 mg；DXM 6mg/(m2· d)，d1～d5。sanlianqiaozhu，d1。5.yanchiqianghuaⅡzhiliao（1）VDLD fangan：zhongweizubingrenwanchengzhongjianweichizhiliaohoufuchagusui，bingxingliuzaopinggu，chuyuwanquanhuanjiezhuangtai，jinruyanchiqianghuaⅡzhiliao。danghuanerwufare、wuyanzhongganran；ANC≥1×109/L，PLT≥100×109/L shikekaishicifanganhualiao。jutiyaowuruxia：VCR 1.5 mg/(m2· d)，meizhou 1 ci，gong 3 ci，d1、d8、d15，meicizuidajueduiliangbuchaoguo 2 mg；DNR huoameisu（ADR）25 mg/(m2· d)，meizhou 1 ci，gong 3ci，d1、d8、d15；L-asp 10000 u/(m2· d)，jirouzhushe，Q2d，d1、d4、d7、d10，gong 4 ci；L-ASP guominkeyupeimendongmei（PEG-ASP）2500 IU/m2，jirouzhushe，d4，gong 1 ji。DXM 8-10mg/(m2· d)，d1～d7，d15～d21；sanlianqiaozhu：d1。(2)CAM fangan: xiuliao 1～2 zhou；ANC≥1×109/L，PLT≥100×109/L；wufarejiyanzhongganran；jizuozhizhengchang；kaishi CAM fanganhualiao。jutiyaowuruxia：huanlinzuoan（CTX）1000 mg/(m2· d)，1 ci，d1，shuihuajianhua 3 tian；meisina 400dmg/(m2· ci)，yujingmaidizhu CTX de 0h、4h、8h，d1；atangbaozuo（Ara-C）75 mg/(m2· d) ，d3～d6，d10～d13,gong 8 tian；6-zuojizuozuo（6-MP）60 mg/(m2· d) ，gong 14 tian。sanlianqiaozhu，d3。6.weichizhiliaofangan：diweizuhegaoweizubingrenwanchengyanchiqianghuaＩhoujinruweichizhiliaojieduan。ji 6-MP+MTX fanganqijianmei 4 zhoucharu VDfanganyici。kaishiweichizhiliaoshixingliuzaopinggu，weichizhiliaoqiansigexunhuanmei 8zhoupingguyici（baokuogusuijiancha），yihoumei 8 zhouxiaopingguyici（jiandanyingxiangxuejiancha，wuguchuan、yaochuan），mei 16 zhoudapinggu 1 ci（baokuonaojiyehegusuijiancha）。（1）6-MP+MTX fangan：6-MP 50 mg/(m2· d)，chixushuiqiankongfukoufu；MTX 20 mg/m2，meizhou 1 ci，koufuhuojirouzhushegenju WBC diaozhengfanganzhongdeyaowujiliang。（2）VD fangan：VCR 1.5 mg/(m2·d)，1 ci，meicizuidajueduiliangbuchaoguo 2 mg；DXM 6～8 mg/(m2· d)，d1～d5。- 24 -zongzhiliaoliaocheng： yue 2.5 nian。（san）LBL fufahoudezhiliaoceluedayue 10%～20%jinzhanqi LBL shunanzhihuofufabingli。huanjiehouyidanfufa，wangwangbingqingjiqixiongxian，xunsuquanshenduozangqizhuanyi，zaicihuanjiekunnan，yuhoujicha，shengcunlvjinwei 10%～30%。bujiuzhiliaozhuyaobaokuozaiciyoudaohezaoxueganxibaozhichideqianghuazhiliao。bujiudemubiaoshijinkuaidadaowendingdeercihuanjie（second complete remission， CR2），jinzaoxingzaoxueganxibaoyizhi（haematopoietic stem cell transplant，HSCT）。wanjiuhualiaochangyongdeerxianzhiliaodexibaoduleiyaowuyouyihuanlinzuoan、qujiayangrouhongmeisu、kabodeng。xianyoushujubiaomingfufa LBL weijing HSCT jihuwuzhiyudejihui，erxiangbizitiHSCT（autologous HSCT，auto-HSCT），yijiyin HSCT（allogenic-HSCT，allo-HSCT）suiyoujiaogaodezhiliaoxiangguansiwang，danjuyougenggaodewubingshengcunlv，auto-HSCT fufalvmingxiangaoyu allo-HSCT。1.T-LBL wanjiuzhiliao（1）nailabin（Nelarabine，Arranon）：shituoyangniaozuoleisiwu 9-b-D-atangzuozuotangniaozuozuo（ara-G）deqiantiyaowu，dui Tlinbamuxibaode DNA hechengjuyouxuanzexingyizhizuoyongerzhixibaosiwang。shiyizhongyouxiaode T xibaoteyixingxibaoduyaowu，yongyuzhiliaonanzhi、fufade T-LBL/ALL，takedanyaozhiliaohuoyuqitaxibaoduyaowulianyong。ertongyingyongjiliang 650 mg/(m2· d) ×5 d，21d yiliaocheng，Ⅰ/Ⅱqiertongjichengrenyanjiu，danyaofanyinglv 14%～55%。changjiandefuzuoyongweijiliangyilaixingshenjingduxing，biaoxian 2 jihuo 3 jiganjue、yundongshenjingbingbianhejirouguzuotengtong，youdebingrenbiaoxiantoutong、shishui、ganjuechidun、zuozuofazuo、gongjishidiaodeng，duoweikenixingde。qitafuzuoyongweixueyeduxing、exinoutudengxiaohuadaofanying。nailabinzhiliaofufa/nanzhi T-ALL/LBL zuichangyongdelianhehualiaoshihuanlinzuoanjiayituobozuo，Leah dengbaodao 5/7 CR，qizhong 4 lideyijinxing HSCT，danjin 1 licunhuo，qitabingrensiyujibingjinzhanhezhiliaoxiangguanhebingzheng。chuliaolianhehualiao，K Burley baodao 1 liyizhihoufufadeT-ALL caiyongnailabinjiagongzhexibaohuishudadaochixu CR。Annalisa dengtichukeyigenjubingrenjiyinbiaodapu，banailabinxuanzexingdilianhe PI3K、Bcl2、MEK yizhiji，yizengjiaqiliaoxiao。（2）daleimudankang（Daratumumab）：CD38 renyuanhuadankang，CD38kangyuanzaihualiaoqianhouhuozaifufahouT-ALL/LBLxibaoshangbiaodawending，kenengchengweilianghaodezhiliaobadian。bingkezuowei CAR-T xibaozhiliaodebadian，muqianjunzaitansuozhong。（3）qita：ru PI3K yizhiji、mTOR yizhijihuo PI3K-mTORshuangzhongyizhijilianhetangpizhijisuyongyugaowei PTEN queshidebingren；lusuolitini（ruxolitinib）：JAK/STAT tongluyizhiji，nenggoukefutangpizhijisunaiyaodengjunzaiyanjiuzhong。2.B-LBL wanjiuzhiliao（1）laoansuanjimeiyizhiji（TKI）：keyongyuzhiliaochuzhihefufade Ph+ALL / LBL，tongguobaxiangzuoyongyu BCR/ABL ronghejiyincongerfahuiliaoxiao。yimatinidanyaoyouxiaolvda 70%，lianhehualiao CR lvkeda90%。dierdaidashatiniheniluotinikeyongyuduiyimatininaiyaodebingren，juyoutouguoxuenaopingzhangdetexing，liaoxiaoyouyuyimatini。（2）CD19 teyixingqianhekangyuanshouti T xibao（CAR T xibao）：zhiliaofufa/nanzhi B-ALL/LBL CR lvdadao 70%～92%，liaoxiaoxianzhu，huanjiehoukeqiaojieyizhi，CAR-T xibaozhiliaodeduxingweixibaoyinzishifangzonghezhengheshenjingduxing。（3）qitarushuangteyixingkangti（Blinatumomab）、pengtizuomi（Bortezomib）deng，zhiliaofufa/nanzhiALL/LBLjunyouyidingliaoxiao。（si）zaoxueganxibaoyizhi1.duihualiaoguochengzhongduogepinggudianxianshiduihualiaobumingan，zhongqipingguyou mingquecan liubing zao；huo cunzaiyu houbu liangjiyin ：juyout(9;22)/BCR-ABL1、MLL zhongpaideng，keangaoweizufanganhualiao，wanchengsanliaochenggaoweifanganbaokuo HR-1、HR-2、HR-3 houxingyijiyinzaoxueganxibaoyizhi。2.duiyuyuanfaliuzaofufahuogusuifufahuozhiliaozhongjinzhandebingrentongguowanjiuzhiliaonenggoudadaowanquanhuanjiehuobufenhuanjiehuodeyizhijihuizhe，xujinkuaixingyijiyinzaoxueganxibaoyizhi。liu、hebingzhengdechuli（yi）duicunzaishangqiangjingmaiyapozonghezheng、qidaogengzudebingrendechuliyuanzedayue 10%T-LBL kenengchuxianyanzhongdeqidaogengzu（banhuobubanshangqiangjingmaiyapozonghezheng），weizhenzhengzhongliujizheng。1.duicileibingrenshangweijingbingliquezhenzhe，jinjiyingyongquanshenmazuishoushuhuojian。2.kexianyuxiaohualiao（ruponisong 60 mg/m2koufuhuo VP fangan）huanjiehuxikunnan，yuyongyaohou 24～48 xiaoshineizhengzhuangkongzhihoujinzaoxingbinglijiancha，bingyingxuanzeqinxixingzuixiaodecaozuoquezhen，keyikaolvqucaishunxuwei：gusui、xiongfushui、qianbiaolinbajie、pifuhuoqitaqianbiaokeyiliuzao、shenbulinbajiehuozhongwuchuancihuojian、liuzaoshoushuquhuojian。hualiaoqianxuqianshuweiquezhenhualiaoxieyishu，gaozhijiachanghualiaokenengyingxiangbinglijieguoerwufaquezhen。3.duibanyoushangqiangjingmaiyapozonghezhengdebingrenyingbimianshangzhishuye。（er）zhongliurongjiezonghezhengdechulicunzaigaozhongliufuhede、hualiaoqianyiyougaoniaosuanxuezheng、shengongnengsunhai、shaoniaoshuizhongdebingrenweifashengzhongliurongjiezonghezhengdegaoweirenqun，xucaiqujijideyufanghezhiliaocuoshi。1.yanmijiancegexiangshengmingtizheng、churuliang、tizhong、xuedianjiezhi、ganshengongneng。2.yingyongbiezuochunjianshaoniaosuanshengcheng：10mg/(kg· d)[300mg/(m2· d)]，fen2～3cikoufu。biyaoshiyingyongniaosuanyanghuamei0.1～0.15 mg/(kg·ci)kexunsujiangdiniaosuanshuiping。3.jijishuihualiniao：3000 ml/(m2· d)[125 ml/(m2· h)]，yong1/4～1/3zhangyeti，yibanbuyonghanjiaye。geiyusuniao0.5～1mg/(kg·ci)，Q12hliniao，baozhengchurupingheng，weichiniaoliangdayuezai125 ml/(m2· h)。buchongzugouyeti，kebubijianhua，yifangjianhuatiaojianxialinsuanyanhehuangzuozuozaishenxiaoguanchenjijinyibujiazhongshensunshang。（san）duiyoushenjingxitongqinfanhuoyapodebingrenchuliyuanzejinkuaiwanshanjiancha，jinzaohualiao，yifangnao、jisuihuozhouweishenjingyapohuoqinfanguojiu，zaochengshenjingxitonggongnenghuifuyanchishenzhibukenidesunshang。bingan CNS2、CNS3 geiyuqiaozhu。qi、zhiliaozhongqitazhuyishixiang（yi）hualiaohoujiancexuechanggui，ANC ＜0.5×109/L，PLT＜100×109/L，kepixiazhushelixibaocijiyinzi（G-CSF）5μg/(kg·d)zhiANC＞1×109/Ltingyong。（er）hualiaoyaowudufufanyingdepandingbiaozhunan NCI buliangfanyingdefenjibiaozhun（CTCAE version 4.0，2009)jiance，hualiaoqianhoujunxuzhuyijiancexindiantu、chaoshengxindongtu、ganshengong、niaochanggui、xuedianfenmei、ningxuegongnengdengjiayiyufang。（san）yufangkashifeinangchongfeiyanchangguikoufufufanghuanganyizuo[25 mg/(kg· d)，meitian 2 ci]，meizhoufu 3 tianting 4tian，hualiaokaishizhidaohualiaojieshuhou 3geyue。HD-MTXyongqian 24 xiaoshidaoyong MTX houzhishao 72 xiaoshitingyongfufanghuanganyizuo。ba、tingyaohousuizhenshijianjipingguneirong（yi）shoucipinggu(tingyao 3 geyue)fuchagusuichanggui、jiyinhe MRD；liuzaopinggubaokuo B chao、CT deng，zuihaozuo PET/CT；fuchamianyigongnengjixindiantu、xinzangcaichao；fuchaganshengong、LDH。（er）tingyaodi 1、2 nianmei 3 geyue 1 cijiandanpinggu，baokuoguchuanheliuzaodeyingxiangxuejiancha（B chaohe CT pingsao）jigangonghe LDH。mei 6 geyue 1 cidapinggu，baokuoguchuanheliuzaopinggu：xiangguan B chao、zengqiang CT jianchahuo MR、mianyigongneng、gangonghe LDH deng。（san）tingyaodi 3 nianyihoumeibannianpinggu 1 ci，zhuyaozuoguchuanheliuzaodeyingxiangxue（B chaoheCT pingsao）jigangonghe LDH。shiqingkuangjiazuoneifenmijisujizhishangdengjiancha。jiu、zhuanzhentiaojian（yi）dangdiyiyuanmeiyouzhenliaotiaojian、meiyouzhiliaojingyandexujiangbingrenzhuanzhenzhiyouzhiliaotiaojiandeshangjiyiyuanyibaozhengliaoxiao。（er）juyougaozhongliufuhehuozhongliuhebingzhengdeweizhongbingrenxuzhuanzhenzhiyoujingyandeshangjiyiyuanyiwanjiushengming。（san）jingshangjiyiyuanzhiliaohouwending、dadaowanquanhuanjiedebingrenkezhuanzhenzhiyouzhiliaotiaojiandexiayijiyiyuanjixuzhiliao，liruweichizhiliaodebingren。qijianjianyidingqihuishangjiyiyuanjinxingliuzaopinggu。ruweichiqijianfashengyanzhongdehebingzheng，ruyanzhongganran，kezhuanhuishangjiyiyuanjinxingqiangjiu。fu ertonglinbamuxibaolinbaliuzhenliaoguifan（2019 nianban）bianxieshendingzhuanjiazu（anxingshibihuapaixu）zuchang：wangtianyouchengyuan：wangtianyou、sunxiaofei、zhangyonghong、tangjingyan、jinling、yangzuo、duanyanlong、zhouchunju、gaozifen、dixiaowen
十(厂丑颈)一(驰颈)月(驰耻别)十(厂丑颈)六(尝颈耻)日(搁颈)申(厂丑别苍)时(厂丑颈)，珍(窜丑别苍)贵(骋耻颈)妃(窜耻辞)金(闯颈苍)棺(骋耻补苍)永(驰辞苍驳)远(驰耻补苍)奉(贵别苍驳)安(础苍)事(厂丑颈)宜(驰颈)。奉(贵别苍驳)安(础苍)预(驰耻)日(搁颈)，敬(闯颈苍驳)谨(闯颈苍)包(叠补辞)裹(骋耻辞)。
随着时间的流逝，曾经的那些失望和挫败已经在我的心中渐渐沉淀，成为了我成长的催化剂。我用自己的双手和智慧，一点一滴地积累起了可以支撑梦想的力量。无数次日夜颠倒的努力和学习，让我终于以优异的成绩完成了我的大学学业。虽然那笔被拒绝的学费给我的生活带来了巨大的挑战，但它却没有阻止我前进的脚步。这三大星座男，把你追到手了就不珍惜原创2023-10-24 20:59·星座不求人这三大星座男，把你追到手了就不珍惜白羊男白羊座为什么三分钟热度还不是白羊男搞出的名声越容易得到越不珍惜追到手后态度就变了白羊男没得到时非常迫切喜欢把对方一切都美化等追到手发现和想的不一样自然就不会珍惜了而且白羊喜欢有挑战的东西已经到手的就没意思了所以如果不是真动心的前提下八成是要对感情不负责任了你问那些白羊座为什么追到手就下头？他反问你：考试完你还看书吗简直就是渣男言论如果遇到白羊男这么对你不用生气，不必惋惜早点和这种人划清界限就算是最好的解脱了水瓶座水瓶男做事情向来没定律也许今天还非常喜欢你明天就对你没感觉了这个谁也摸不准规律加上水瓶男是颜控看见漂亮的容易上头花言巧语过后追到了手又觉得没有之前的兴趣了水瓶男从来是兴趣使然无论是追人还是做事只要提不起兴趣了水瓶男一定会迅速退场风趣幽默追你的是他忽冷忽热找不到人的也是他这也是为什么那么多人觉得和水瓶男恋爱不靠谱只能说水瓶男太没规矩了以后遇到这样的水瓶男最好不要轻易答应他多考验他一下才是正解双子男双子男太随心所欲了追你的时候就由着性子追到手了更是由着心情真的太不靠谱了一旦双子男失去了新鲜感他就容易做逃兵追你的时候胡乱承诺到后来一样没实现双子男的灵魂太自由了除非对方有一片大海否则困不住他这个海王没几天就突然失踪了说白了就是没责任感喜欢暧昧又不负责任也难怪那么多人骂双子座花心的名声都是双子男搞出来的如果想和双子男长久就要提前跟他欲擒故纵多考虑一阵子再答应他才是对自己的感情负责《漂亮的保姆5观看翻译中文版》现代都市,动作,女频恋爱 _成全...《漂亮的保姆》电影完整版免费观看 - 瓦力影视
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