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New Approaches to Treating Challenging Subtypes of ALL in AYA Patients.


ABSTRACT:

Purpose of review

The treatment of acute lymphoblastic leukemia (ALL) in adolescent and young adult (AYA) patients has markedly improved with the adoption of pediatric-inspired protocols. However, there remain several subtypes of ALL that represent significant therapeutic challenges. Here, we review the current evidence guiding treatment of Philadelphia chromosome-positive (Ph+), Philadelphia chromosome-like (Ph-L), and early T-precursor (ETP) ALL in the AYA population.

Recent findings

Clinical trials in Ph + ALL have demonstrated the superior efficacy of second- and third-generation tyrosine kinase inhibitors (TKIs) to induce and maintain remission. Current efforts now focus on determining the durability of these remissions and which patients will benefit from transplant. For Ph-like and ETP ALL, recent studies are investigating the addition of novel agents to standard treatment. The treatment of Ph + ALL has significantly improved with the addition of potent TKIs. However, the treatment of Ph-like and ETP ALL remains a challenge. At this time, the judicious use of allogenic transplant is the only current approach to modify this increased risk.

SUBMITTER: Prescott K 

PROVIDER: S-EPMC8279222 | biostudies-literature | 2020 Dec

REPOSITORIES: biostudies-literature

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Publications

New Approaches to Treating Challenging Subtypes of ALL in AYA Patients.

Prescott Kevin K   Jacobs Michael M   Stock Wendy W   Wynne Joseph J  

Current hematologic malignancy reports 20201201 6


<h4>Purpose of review</h4>The treatment of acute lymphoblastic leukemia (ALL) in adolescent and young adult (AYA) patients has markedly improved with the adoption of pediatric-inspired protocols. However, there remain several subtypes of ALL that represent significant therapeutic challenges. Here, we review the current evidence guiding treatment of Philadelphia chromosome-positive (Ph+), Philadelphia chromosome-like (Ph-L), and early T-precursor (ETP) ALL in the AYA population.<h4>Recent finding  ...[more]

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