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Review
. 2020 Dec;15(6):424-435.
doi: 10.1007/s11899-020-00597-y.

New Approaches to Treating Challenging Subtypes of ALL in AYA Patients

Kevin Prescott  1 , Michael Jacobs  1 , Wendy Stock  1 , Joseph Wynne  2
Affiliations
Review

New Approaches to Treating Challenging Subtypes of ALL in AYA Patients

Kevin Prescott et al. Curr Hematol Malig Rep. 2020 Dec.

Abstract

Purpose of review: The treatment of acute lymphoblastic leukemia (ALL) in adolescent and young adult (AYA) patients has markedly improved with the adoption of pediatric-inspired protocols. However, there remain several subtypes of ALL that represent significant therapeutic challenges. Here, we review the current evidence guiding treatment of Philadelphia chromosome-positive (Ph+), Philadelphia chromosome-like (Ph-L), and early T-precursor (ETP) ALL in the AYA population.

Recent findings: Clinical trials in Ph + ALL have demonstrated the superior efficacy of second- and third-generation tyrosine kinase inhibitors (TKIs) to induce and maintain remission. Current efforts now focus on determining the durability of these remissions and which patients will benefit from transplant. For Ph-like and ETP ALL, recent studies are investigating the addition of novel agents to standard treatment. The treatment of Ph + ALL has significantly improved with the addition of potent TKIs. However, the treatment of Ph-like and ETP ALL remains a challenge. At this time, the judicious use of allogenic transplant is the only current approach to modify this increased risk.

Keywords: ALL; AYA; ETP; Ph + ALL; Ph-like.

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Conflict of interest statement

Conflicts of Interest

Dr. Prescott has nothing to disclose.

Dr. Jacobs has nothing to disclose.

Dr. Stock reports personal fees from AMGEN, personal fees from ABBVIE, personal fees from PFIZER, personal fees from JAZZ, personal fees from ADAPTIVE BIOTECHNOLOGIES, during the conduct of the study; personal fees from ASTELLAS, personal fees from UP TO DATE, outside the submitted work; .

Dr. Wynne reports personal fees from Servier, outside the submitted work.

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