Evolving paradigms in the therapy of Philadelphia chromosome–negative acute lymphoblastic leukemia in adults
- 1 January 2009
- journal article
- review article
- Published by American Society of Hematology in Hematology
- Vol. 2009 (1), 362-370
- https://doi.org/10.1182/asheducation-2009.1.362
Abstract
Important studies challenging previous approaches to the treatment of adults with Philadelphia chromosome–negative acute lymphoblastic leukemia (ALL) have emerged in the past decade. Donor versus no donor comparisons of allogeneic transplant highlight a potent graft-versus-leukemia effect in ALL, and the application of reduced-intensity conditioning transplants may exploit this effect while reducing non-relapse mortality. The adoption of the use of pediatric intensity-type regimens in adolescents and young adults shows promise to improve outcomes in this population. New therapeutic targets such as mutations in NOTCH1 in T-cell ALL and CD22 in pre-B ALL are being exploited in clinical trials. The application of molecular techniques and flow cytometry to quantitate minimal residual disease will allow further stratification of patients by risk. Although the outcomes of adults with ALL lag behind the stunningly successful results seen in children, new paradigms and new discoveries bring hope that this disparity will steadily lessen.Keywords
This publication has 39 references indexed in Scilit:
- Prognostic significance of CD20 expression in adults with de novo precursor B-lineage acute lymphoblastic leukemiaBlood, 2009
- Myeloablative allogeneic versus autologous stem cell transplantation in adult patients with acute lymphoblastic leukemia in first remission: a prospective sibling donor versus no-donor comparisonBlood, 2009
- Minimal Residual Disease in Acute Lymphoblastic LeukemiaSeminars in Hematology, 2009
- The role of NOTCH1 signaling in T-ALLHematology-American Society Hematology Education Program, 2009
- What determines the outcomes for adolescents and young adults with acute lymphoblastic leukemia treated on cooperative group protocols? A comparison of Children's Cancer Group and Cancer and Leukemia Group B studiesBlood, 2008
- Acute lymphoblastic leukemia in adolescents and young adults in FinlandHaematologica, 2008
- Chemoimmunotherapy Reinduction With Epratuzumab in Children With Acute Lymphoblastic Leukemia in Marrow Relapse: A Children's Oncology Group Pilot StudyJournal of Clinical Oncology, 2008
- Nelarabine induces complete remissions in adults with relapsed or refractory T-lineage acute lymphoblastic leukemia or lymphoblastic lymphoma: Cancer and Leukemia Group B study 19801Blood, 2007
- Treatment outcome in young adults and children >10 years of age with acute lymphoblastic leukemia in SwedenCancer, 2006
- Prognostic importance of measuring early clearance of leukemic cells by flow cytometry in childhood acute lymphoblastic leukemiaBlood, 2002