Adult Acute Lymphoblastic Leukemia.
Conventional cytotoxic chemotherapy used to treat acute lymphoblastic leukemia (ALL) results in high cure rates in pediatric patients but is suboptimal in the treatment of adult patients. The 5-year overall survival is approximately 90% in children and 30% to 40% in adults and elderly patients. Adults with ALL tend to have higher risk factors at diagnosis, more comorbidities, and increasing age that often requires dose reductions. Major advancements have been made in redefining the pathologic classification of ALL, identifying new cytogenetic-molecular abnormalities, and developing novel targeted agents in order to improve survival. The addition of new monoclonal antibodies and tyrosine kinase inhibitors to conventional chemotherapy in the frontline setting has resulted in increased rates of complete remission and overall survival. These new developments are changing the treatment of adult ALL from a "one therapy fits all" approach to individualized treatment based on patient's cytogenetic and molecular profile.
Department of Leukemia, University of Texas MD Anderson Cancer Center, Houston, TX.
Shilpa
S
Paul
Department of Leukemia, University of Texas MD Anderson Cancer Center, Houston, TX.
Hagop
H
Kantarjian
Department of Leukemia, University of Texas MD Anderson Cancer Center, Houston, TX. Electronic address: ejabbour@mdanderson.org.
Elias J
EJ
Jabbour
D000328:Adult; D018033:Antibodies, Bispecific / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001853:Bone Marrow / Q000473:pathology; D016543:Central Nervous System Neoplasms / Q000517:prevention & control; D006801:Humans; D016219:Immunotherapy, Adoptive; D000080045:Inotuzumab Ozogamicin; D018365:Neoplasm, Residual; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology / Q000628:therapy*; D047428:Protein Kinase Inhibitors / Q000627:therapeutic use; D011948:Receptors, Antigen, T-Cell / Q000276:immunology; D016879:Salvage Therapy; D033581:Stem Cell Transplantation; D013601:T-Lymphocytes / Q000276:immunology / Q000637:transplantation
D018033:Antibodies, Bispecific; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; D047428:Protein Kinase Inhibitors; D011948:Receptors, Antigen, T-Cell; C510808:blinatumomab; C527517:ofatumumab; D000080045:Inotuzumab Ozogamicin