title: Treatment of Young Adults with Acute Lymphoblastic Leukemia.
abstract: Young adults with acute lymphoblastic leukemia are a distinctive category of patients, with substantial difference in disease biology and response to therapy; hence, they pose unique challenges and issues beyond those faced by children and older adults. Despite inferior survival compared to children, there is growing evidence to suggest that young adults have improved outcomes when treated with pediatric-based approaches. With better supportive care and toxicity management and multidisciplinary team and approach, we have made great improvement in outcomes of young adults with ALL. However, despite significant progress, patients with persistence of minimal residual disease have a poor prognosis. This review discusses current controversies in the management of young adults with ALL, outcomes following pediatric and adult protocols, and the role of allogeneic stem cell transplantation. We also explore recent advances in disease monitoring and highlight our approach to incorporation of novel therapies in the management of young adults with ALL.
authors.affiliation: Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
authors.forename: Ankit
authors.initials: A
authors.lastname: Kansagra
authors.affiliation: Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA. litzow.mark@mayo.edu.
authors.forename: Mark
authors.initials: M
authors.lastname: Litzow
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000970:Antineoplastic Agents / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D001215:Asparaginase / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy; D019468:Disease Management; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007167:Immunotherapy; D058990:Molecular Targeted Therapy; D010677:Philadelphia Chromosome; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000209:etiology / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents; D001215:Asparaginase
keywords: Adolescent and young adults; Asparaginase; Hematopoietic stem cell transplant; Monoclonal antibodies; Philadelphia chromosome; Supportive care