Acute lymphoblastic leukemia in adolescents and young adults.
Acute lymphoblastic leukemia (ALL) in the adolescent and young adult (AYA) population is a difficult clinical problem. The AYA population, generally regarded as patients aged 15 to 39 years, currently draws a good deal of attention, particularly in the area of therapy selection. The current trend is to treat this group of patients with leukemia regimens based on pediatric protocols, and results comparing pediatric approaches versus adult approaches to treatment are maturing. Results are pending from a large US trial in which pediatric-based treatment is given to AYA patients with ALL. In tandem with these new clinical trials, researchers have reported disease features in the AYA group that may explain some of the differences in response to treatment observed in the AYA population compared with the pediatric population. In addition, unique social factors in this age group add to the complexity of ALL therapy in the AYA population. AYA patients are developing independence and separating from their parents. They tend to be noncompliant. Young adults suffer from a lack of health care insurance and poor access to clinical trials, and have specific concerns regarding toxicities, in particular fertility. Cancer 2017;123:2398-403. © 2017 American Cancer Society.
Department of Pediatrics-Patient Care, Children's Cancer Hospital, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Michael E
ME
Rytting
Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Elias J
EJ
Jabbour
Chao Family Comprehensive Cancer Center, University of California at Irvine, Orange, California.
Susan M
http://orcid.org/0000-0003-3386-6540
SM
O'Brien
Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Hagop M
HM
Kantarjian
D000293:Adolescent; D041923:Adolescent Development; D000328:Adult; 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*; D001087:Arabinonucleosides / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D059247:Fertility Preservation; D006297:Health Services Accessibility; D006801:Humans; D000080045:Inotuzumab Ozogamicin; D007348:Insurance, Health; D010349:Patient Compliance; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000235:genetics / Q000628:therapy*; D011379:Prognosis; D000069283:Rituximab / Q000627:therapeutic use; D033581:Stem Cell Transplantation; D014178:Translocation, Genetic / Q000235:genetics; D014184:Transplantation, Homologous; D014314:Trisomy / Q000235:genetics; D055815:Young Adult
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; D001087:Arabinonucleosides; D000069283:Rituximab; C104457:nelarabine; C527517:ofatumumab; D000080045:Inotuzumab Ozogamicin
acute lymphoblastic leukemia (ALL); adolescent and young adult (AYA); outcomes; precursor B ALL