TY - JOUR
T1 - Continuing challenges and current issues in acute lymphoblastic leukemia
AU - Kansagra, Ankit
AU - Dahiya, Saurabh
AU - Litzow, Mark
N1 - Publisher Copyright:
© 2017 Informa UK Limited, trading as Taylor & Francis Group.
PY - 2018/3/4
Y1 - 2018/3/4
N2 - Conventional cytotoxic chemotherapy used to treat acute lymphoblastic leukemia (ALL) has resulted into high cure rates for pediatric patients, however outcomes for adult patients remain suboptimal. The 5-year overall survival is only 30–40% in adults and elderly patients with ALL compared to 90% in children. We have seen major advances in our understanding and management of ALL related to identification of new cytogenetic and molecular abnormalities and development of novel targeted agents for the treatment of ALL. The addition of tyrosine kinase inhibitors, monoclonal antibodies and novel immune therapies (e.g. bispecific T cell engager [BiTE] and chimeric antigen receptor [CAR] T cells) has resulted in improved outcomes. These new developments are changing the treatment paradigm of adults ALL from a ‘one size fits all’ approach to a more individualized treatment approach based on immunophenotypic, cytogenetic and molecular features. In this article we review recent diagnostic and therapeutic advances along with the challenges in the treatment of patients with ALL.
AB - Conventional cytotoxic chemotherapy used to treat acute lymphoblastic leukemia (ALL) has resulted into high cure rates for pediatric patients, however outcomes for adult patients remain suboptimal. The 5-year overall survival is only 30–40% in adults and elderly patients with ALL compared to 90% in children. We have seen major advances in our understanding and management of ALL related to identification of new cytogenetic and molecular abnormalities and development of novel targeted agents for the treatment of ALL. The addition of tyrosine kinase inhibitors, monoclonal antibodies and novel immune therapies (e.g. bispecific T cell engager [BiTE] and chimeric antigen receptor [CAR] T cells) has resulted in improved outcomes. These new developments are changing the treatment paradigm of adults ALL from a ‘one size fits all’ approach to a more individualized treatment approach based on immunophenotypic, cytogenetic and molecular features. In this article we review recent diagnostic and therapeutic advances along with the challenges in the treatment of patients with ALL.
KW - Acute lymphoblastic leukemia
KW - Philadelphia chromosome
KW - allogeneic stem cell transplant
KW - chimeric antigen receptor T
KW - minimal residual disease
KW - monoclonal antibodies
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U2 - 10.1080/10428194.2017.1335397
DO - 10.1080/10428194.2017.1335397
M3 - Review article
C2 - 28604239
AN - SCOPUS:85020735875
SN - 1042-8194
VL - 59
SP - 526
EP - 541
JO - Leukemia and Lymphoma
JF - Leukemia and Lymphoma
IS - 3
ER -