title: The Approach to Acute Lymphoblastic Leukemia in Older Patients: Conventional Treatments and Emerging Therapies.
abstract: Acute lymphoblastic leukemia (ALL) among older adult patients presents significant clinical challenges. As opposed to pediatric populations, in whom long-term outcomes are markedly superior, those for adults remain grim. Nevertheless, younger adults with ALL have experienced a steady improvement in long-term survival in the last few decades. This is significantly different for older ALL patients, for whom long-term outcomes remain poor. Conventional chemotherapies are associated with sub-optimal outcomes and increased toxicity in this population. However, several emerging therapies, including antibody-drug conjugates, bi-specific engagers, and chimeric antigen receptor (CAR) T cells, have demonstrated much promise and are either incorporated into the existing therapeutic paradigms or being actively investigated to improve outcomes.
authors.affiliation: Stanbury Service PSP Group, Department of Medicine, Massachusetts General Hospital, Boston, MA, 02114, USA.
authors.forename: Victor D
authors.initials: VD
authors.lastname: Fedorov
authors.affiliation: Department of Medicine, Massachusetts General Hospital, Boston, MA, 02114, USA.
authors.forename: Vivek A
authors.initials: VA
authors.lastname: Upadhyay
authors.affiliation: Harvard Medical School, Massachusetts General Hospital, Division of Hematology and Medical Oncology, Zero Emerson Place, Suite 118, Boston, MA, 02114, USA. afathi@partners.org.
authors.forename: Amir T
authors.initials: AT
authors.lastname: Fathi
mesh_terms: D018033:Antibodies, Bispecific / Q000235:genetics / Q000378:metabolism; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D064987:Cell- and Tissue-Based Therapy / Q000379:methods*; D018380:Hematopoietic Stem Cell Transplantation; D006412:Hematopoietic Stem Cells / Q000166:cytology / Q000378:metabolism; D006801:Humans; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy / Q000401:mortality / Q000628:therapy*; D047428:Protein Kinase Inhibitors / Q000627:therapeutic use; D011948:Receptors, Antigen, T-Cell / Q000235:genetics / Q000378:metabolism; D011993:Recombinant Fusion Proteins / Q000096:biosynthesis / Q000235:genetics; D015996:Survival Rate
chemical_list: D018033:Antibodies, Bispecific; D000970:Antineoplastic Agents; D047428:Protein Kinase Inhibitors; D011948:Receptors, Antigen, T-Cell; D011993:Recombinant Fusion Proteins
keywords: Acute lymphoblastic leukemia; CAR T cells; Older patients