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Treatment of Acute Lymphoblastic Leukemia in Adolescents and Young Adults
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Treatment of Acute Lymphoblastic Leukemia in Adolescents and Young Adults
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Treatment of Acute Lymphoblastic Leukemia in Adolescents and Young Adults
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Journal Article
Treatment of Acute Lymphoblastic Leukemia in Adolescents and Young Adults
2011
Overview
Treatment approaches for adolescents and young adults with acute lymphoblastic leukemia (ALL) have evolved considerably in the past 5–7 years. One of the major changes has been the widespread adoption of pediatric-based protocols, which appears to have significantly improved survival and probably renders allogeneic hematopoietic stem cell transplantation (HSCT) unnecessary in most standard-risk patients. However, high-risk patients, such as those with BCR-ABL or MLL rearrangements or high white count presentations, should still be referred for HSCT in CR-1. Minimal residual disease positivity has also been identified as a high-risk feature. Patients with BCR-ABL–positive ALL should receive combined therapy with a tyrosine kinase inhibitor and chemotherapy prior to HSCT. The adoption of pediatric-based regimens has been associated with significant additional toxicities, including venous thromboembolism, osteonecrosis, other steroid-related changes, and neuropathy, which can potentially have a major adverse impact on the quality of life of these young ALL patients.
Publisher
Current Science Inc
