Frontline treatment of adults with newly diagnosed B-cell acute lymphoblastic leukaemia Review


Authors: Aldoss, I.; Roboz, G. J.; Bassan, R.; Boissel, N.; DeAngelo, D. J.; Fleming, S.; Gökbuget, N.; Logan, A. C.; Luger, S. M.; Menne, T.; Park, J.; Schuh, A. C.; Shah, B.; Jabbour, E.
Review Title: Frontline treatment of adults with newly diagnosed B-cell acute lymphoblastic leukaemia
Abstract: In the past decade, there has been considerable progress in the treatment of adults with newly diagnosed B-cell acute lymphoblastic leukaemia. This evolution is the product of a more profound understanding of acute lymphoblastic leukaemia biology, innovations in measurable residual disease quantification that led to precise disease-risk stratification, adoption of contemporary paediatric-inspired regimens, inclusion of tyrosine kinase inhibitors in the treatment of Philadelphia chromosome-positive acute lymphoblastic leukaemia, and the introduction of immunotherapy in the frontline setting. Nevertheless, outcomes of acute lymphoblastic leukaemia in adults are inferior compared with those of children, with excessive rates of treatment failure, and therapy-related morbidity and mortality. Simultaneously, transplant consolidation has continued to be used frequently for high-risk adults with acute lymphoblastic leukaemia in first complete remission. Considering the rapid pace of evolution in acute lymphoblastic leukaemia management, novel trial designs are warranted to accelerate advancements and streamline approaches. Here, we summarise progress in the treatment of adults with newly diagnosed acute lymphoblastic leukaemia, which adds to previously published guidelines by focusing specifically on first-line decisions for B-cell acute lymphoblastic leukaemia and how to best personalise treatment. This Viewpoint also includes experiences with regimens and testing approaches currently available not only in Europe, but also on multiple continents with different practices and resources. © 2024 Elsevier Ltd
Keywords: adult; child; treatment failure; review; multiple cycle treatment; acute lymphoblastic leukemia; immunotherapy; drug combination; minimal residual disease; diagnosis; remission; drug toxicity; disease management; clinical practice guideline; drug therapy; therapy; pharmacology; b cell leukemia; procedures; humans; human; b cell acute lymphoblastic leukemia; intrathecal drug administration; precursor b-cell lymphoblastic leukemia-lymphoma
Journal Title: The Lancet Haematology
Volume: 11
Issue: 12
ISSN: 2352-3026
Publisher: Elsevier Science, Inc.  
Date Published: 2024-12-01
Start Page: e959
End Page: e970
Language: English
DOI: 10.1016/s2352-3026(24)00285-0
PUBMED: 39638543
PROVIDER: scopus
DOI/URL:
Notes: Review -- Source: Scopus
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  1. Jae Hong Park
    378 Park