How I treat T-cell acute lymphoblastic leukemia in adults

Mark R Litzow, Adolfo A. Ferrando

Research output: Contribution to journalReview article

43 Citations (Scopus)

Abstract

T-cell immunophenotype of acute lymphoblastic leukemia (T-ALL) is an uncommon aggressive leukemia that can present with leukemic and/or lymphomatous manifestations. Molecular studies are enhancing our understanding of the pathogenesis of T-ALL, and the discovery of activating mutations of NOTCH1 and FBXW7 in a majority of patients has been a seminal observation. The use of pediatric intensive combination chemotherapy regimens in adolescents and young adults has significantly improved the outcome of patients with T-ALL. The use of nelarabine for relapsed and refractory T-ALL results in responses in a substantial minority of patients. Allogeneic hematopoietic cell transplantation (HCT) still plays a key role in patients with high-risk or relapsed/refractory disease. γ-Secretase inhibitors hold promise for the treatment of patients with NOTCH1 mutations, and the results of clinical trials with these agents are eagerly awaited. It is recommended that younger patients receive a pediatric-intensive regimen. Older and unfit patients canreceive suitable multiagent chemotherapy and be allocated to HCT based on their response, risk factors, and comorbidities. Although advances in the treatment of T-ALL have lagged behind those of B-cell ALL, it is hoped that the molecular revolution will enhance our understanding of the pathogenesis and treatment of this aggressive lymphoid malignancy.

Original languageEnglish (US)
Pages (from-to)833-841
Number of pages9
JournalBlood
Volume126
Issue number7
DOIs
StatePublished - Aug 13 2015

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T-cells
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Precursor T-Cell Lymphoblastic Leukemia-Lymphoma
T-Lymphocytes
Pediatrics
Chemotherapy
Refractory materials
Cell Transplantation
Amyloid Precursor Protein Secretases
Mutation
Cells
Combination Drug Therapy
Comorbidity
Young Adult
Leukemia
B-Lymphocytes
Therapeutics
Observation
Clinical Trials
Drug Therapy

ASJC Scopus subject areas

  • Hematology
  • Biochemistry
  • Cell Biology
  • Immunology
  • Medicine(all)

Cite this

How I treat T-cell acute lymphoblastic leukemia in adults. / Litzow, Mark R; Ferrando, Adolfo A.

In: Blood, Vol. 126, No. 7, 13.08.2015, p. 833-841.

Research output: Contribution to journalReview article

Litzow, Mark R ; Ferrando, Adolfo A. / How I treat T-cell acute lymphoblastic leukemia in adults. In: Blood. 2015 ; Vol. 126, No. 7. pp. 833-841.
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