Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2020 Jan 16;135(3):159-166.
doi: 10.1182/blood.2019001557.

How I treat newly diagnosed T-cell acute lymphoblastic leukemia and T-cell lymphoblastic lymphoma in children

David T Teachey  1 , David O'Connor  2   3
Affiliations
Case Reports

How I treat newly diagnosed T-cell acute lymphoblastic leukemia and T-cell lymphoblastic lymphoma in children

David T Teachey et al. Blood. .

Abstract

T-cell acute lymphoblastic leukemia (T-ALL) is an aggressive malignancy that has historically been associated with a very poor prognosis. Nevertheless, despite a lack of incorporation of novel agents, the development of intensified T-ALL-focused protocols has resulted in significant improvements in outcome in children. Through the use of several representative cases, we highlight the key changes that have driven these advances including asparaginase intensification, the use of induction dexamethasone, and the safe omission of cranial radiotherapy. We discuss the results of recent trials to explore key topics including the implementation of risk stratification with minimal residual disease measurement and how to treat high-risk subtypes such as early T-cell precursor ALL. In particular, we address current discrepancies in treatment between different cooperative groups, including the use of nelarabine, and provide rationales for current treatment protocols for both T-ALL and T-lymphoblastic lymphoma.

PubMed Disclaimer

Conflict of interest statement

Conflict-of-interest disclosure: D.T.T. serves on advisory boards for Amgen, Janssen, La Roche, and Humanigen; his institution receives grant funding from Novartis. D.O. declares no competing financial interests.

Figures

None
Graphical abstract
Figure 1.
Figure 1.
Overview of current North American and UK T-ALL recommended treatment approaches.
See this image and copyright information in PMC

References

    1. Teachey DT, Pui CH. Comparative features and outcomes between paediatric T-cell and B-cell acute lymphoblastic leukaemia. Lancet Oncol. 2019;20(3):e142-e154. - PMC - PubMed
    1. Schorin MA, Blattner S, Gelber RD, et al. . Treatment of childhood acute lymphoblastic leukemia: results of Dana-Farber Cancer Institute/Children’s Hospital Acute Lymphoblastic Leukemia Consortium Protocol 85-01. J Clin Oncol. 1994;12(4):740-747. - PubMed
    1. Reiter A, Schrappe M, Ludwig WD, et al. . Chemotherapy in 998 unselected childhood acute lymphoblastic leukemia patients. Results and conclusions of the multicenter trial ALL-BFM 86. Blood. 1994;84(9):3122-3133. - PubMed
    1. Nachman JB, Sather HN, Sensel MG, et al. . Augmented post-induction therapy for children with high-risk acute lymphoblastic leukemia and a slow response to initial therapy. N Engl J Med. 1998;338(23):1663-1671. - PubMed
    1. Hastings C, Gaynon PS, Nachman JB, et al. . Increased post-induction intensification improves outcome in children and adolescents with a markedly elevated white blood cell count (≥200 × 10(9)/l) with T cell acute lymphoblastic leukaemia but not B cell disease: a report from the Children’s Oncology Group. Br J Haematol. 2015;168(4):533-546. - PMC - PubMed

Publication types

MeSH terms