SOHO State of the Art Update and Next Questions: Advances in the Treatment of Adult Acute Lymphoblastic Leukemia

Clin Lymphoma Myeloma Leuk. 2019 Aug;19(8):471-479. doi: 10.1016/j.clml.2019.06.011. Epub 2019 Jul 3.

Abstract

The treatment of adult acute lymphoblastic leukemia (ALL) has largely followed the successful pediatric model that uses multi-agent chemotherapy regimens. Although cytotoxic chemotherapy can induce complete remissions, elderly patients are frequently unable to tolerate its intensity owing to toxicities and comorbidities. Elderly patients particularly often relapse, leading to a 5-year overall survival (OS) of only 20%. In an effort to improve outcomes while minimizing toxicities, novel targeted therapies have been developed: monoclonal antibodies against CD19, CD20, and CD22; tyrosine kinase inhibitors; chimeric antigen receptor T-cell therapies; and BH3 mimetics. Here, we discuss advancements in the treatment of ALL and their places in the armamentarium for adult patients.

Keywords: Blinatumomab; Chimeric antigen receptor T-cell therapy; Inotuzumab ozogamicin; Monoclonal antibodies; Tyrosine kinase inhibitors.

Publication types

  • Review

MeSH terms

  • Adult
  • Antigens, Neoplasm / immunology*
  • Antineoplastic Agents, Immunological / therapeutic use*
  • Humans
  • Immunotherapy / methods*
  • Molecular Targeted Therapy*
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / immunology
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / therapy*
  • Prognosis
  • Survival Rate

Substances

  • Antigens, Neoplasm
  • Antineoplastic Agents, Immunological