“SOHO State of the Art Updates and Next Questions” Treatment of ALL

Publication date: Available online 3 April 2018 Source:Clinical Lymphoma Myeloma and Leukemia Author(s): Sabina Chiaretti, Elias Jabbour, Dieter Hoelzer The outcome of adult Acute Lymphoblastic Leukemia (ALL) has substantially improved by adopting pediatric inspired regimens, and about half of the patients are nowadays cured. The evaluation of Minimal Residual Disease (MRD) currently represents the most important prognostic which drive treatment algorithm and which includes allogeneic stem cell transplantation (allo-SCT) allocation. Indeed, for high-risk patients, Stem Cell Transplantation (allo-SCT) should be pursued as soon as possible, while in standard-risk patients this procedure should be avoided also in light of related toxicity and because there are no significant benefits Furthermore, better characterization of the molecular genetic events can drive therapeutic decision: an historical example in this respect is represented by the use of Tyrosine Kinase Inhibitors (TKI) in Philadelphia chromosome positive (Ph+) ALL; in the upcoming future, TKIs might be used also in other subgroups, such as BCR/ABL1-like cases and other with deregulated tyrosine kinases. Finally, the greatest progress is currently achieved with new immunotherapies targeting frequently expressed surface antigens in ALL. It is also a new chance for elderly ALL patients, so far spared from intensive chemotherapy and allo-SCT. These targeted therapies will substantially change this treatment algorith...
Source: Clinical Lymphoma Myeloma and Leukemia - Category: Cancer & Oncology Source Type: research