TY - JOUR
T1 - Current challenges and opportunities in treating adult patients with Philadelphia-negative acute lymphoblastic leukaemia
AU - Wolach, Ofir
AU - Amitai, Irina
AU - DeAngelo, Daniel J.
N1 - Publisher Copyright:
© 2017 John Wiley & Sons Ltd
PY - 2017/12
Y1 - 2017/12
N2 - Significant advances have been made in recent years in the field of Philadelphia-negative acute lymphoblastic leukaemia (ALL). New insights into the biology and genetics of ALL as well as novel clinical observations and new drugs are changing the way we diagnose, risk-stratify and treat adult patients with ALL. New genetic subtypes and alterations refine risk stratification and uncover new actionable therapeutic targets. The incorporation of more intensive, paediatric and paediatric-inspired approaches for young adults seem to have a positive impact on survival in this population. Minimal residual disease at different time points can assist in tailoring risk-adapted interventions for patients based on individual response. Finally, novel targeted approaches with monoclonal antibodies, immunotherapies and small molecules are moving through clinical development and entering the clinic. The aim of this review is to consolidate the abundance of emerging data and to review and revisit the concepts of risk-stratification, choice of induction and post-remission strategies as well as to discuss and update the approach to specific populations with ALL, such as young adult, elderly/unfit and relapsed/refractory patients with ALL.
AB - Significant advances have been made in recent years in the field of Philadelphia-negative acute lymphoblastic leukaemia (ALL). New insights into the biology and genetics of ALL as well as novel clinical observations and new drugs are changing the way we diagnose, risk-stratify and treat adult patients with ALL. New genetic subtypes and alterations refine risk stratification and uncover new actionable therapeutic targets. The incorporation of more intensive, paediatric and paediatric-inspired approaches for young adults seem to have a positive impact on survival in this population. Minimal residual disease at different time points can assist in tailoring risk-adapted interventions for patients based on individual response. Finally, novel targeted approaches with monoclonal antibodies, immunotherapies and small molecules are moving through clinical development and entering the clinic. The aim of this review is to consolidate the abundance of emerging data and to review and revisit the concepts of risk-stratification, choice of induction and post-remission strategies as well as to discuss and update the approach to specific populations with ALL, such as young adult, elderly/unfit and relapsed/refractory patients with ALL.
KW - Philadelphia-negative acute lymphoblastic leukaemia
KW - allogeneic transplantation
KW - high-risk genetic subgroups
KW - novel drugs
KW - paediatric/paediatric inspired therapy
UR - http://www.scopus.com/inward/record.url?scp=85035095705&partnerID=8YFLogxK
U2 - 10.1111/bjh.14916
DO - 10.1111/bjh.14916
M3 - ???researchoutput.researchoutputtypes.contributiontojournal.systematicreview???
C2 - 29076138
AN - SCOPUS:85035095705
SN - 0007-1048
VL - 179
SP - 705
EP - 723
JO - British Journal of Haematology
JF - British Journal of Haematology
IS - 5
ER -