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J Natl Compr Canc Netw. 2019 May 1;17(5):414-423. doi: 10.6004/jnccn.2019.0024.

Guidelines Insights: Acute Lymphoblastic Leukemia, Version 1.2019.

Author information

1
1The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins.
2
2UC San Diego Moores Cancer Center.
3
3UCSF Helen Diller Comprehensive Cancer Center.
4
4Dana-Farber/Brigham and Women's Cancer Center.
5
5Roswell Park Comprehensive Cancer Center.
6
6Massachusetts General Hospital Cancer Center.
7
7University of Washington/Seattle Cancer Care Alliance.
8
8Mayo Clinic Cancer Center.
9
9Case Comprehensive Cancer Center/University Hospitals Seidman Cancer Center and Cleveland Clinic Taussig Cancer Institute.
10
10City of Hope National Medical Center.
11
11The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute.
12
12Huntsman Cancer Institute at the University of Utah.
13
13University of Alabama at Birmingham Comprehensive Cancer Center.
14
14University of Michigan Rogel Cancer Center.
15
15Fred & Pamela Buffett Cancer Center.
16
16Stanford Cancer Institute.
17
17The University of Texas MD Anderson Cancer Center.
18
18Duke Cancer Institute.
19
19University of Colorado Cancer Center.
20
20Yale Cancer Center/Smilow Cancer Hospital.
21
21University of Wisconsin Carbone Cancer Center.
22
22Vanderbilt-Ingram Cancer Center.
23
23Memorial Sloan Kettering Cancer Center.
24
24St. Jude Children's Research Hospital/The University of Tennessee Health Science Center.
25
25Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine.
26
26National Comprehensive Cancer Network; and.
27
27Moffitt Cancer Center.

Abstract

Survival outcomes for older adults with acute lymphoblastic leukemia (ALL) are poor and optimal management is challenging due to higher-risk leukemia genetics, comorbidities, and lower tolerance to intensive therapy. A critical understanding of these factors guides the selection of frontline therapies and subsequent treatment strategies. In addition, there have been recent developments in minimal/measurable residual disease (MRD) testing and blinatumomab use in the context of MRD-positive disease after therapy. These NCCN Guidelines Insights discuss recent updates to the NCCN Guidelines for ALL regarding upfront therapy in older adults and MRD monitoring/testing in response to ALL treatment.

PMID:
31085755
DOI:
10.6004/jnccn.2019.0024

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