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ACUTE LYMPHOBLASTIC LEUKEMIA

Optimizing the treatment of acute lymphoblastic leukemia in younger and older adults: new drugs and evolving paradigms

Leukemia volume 35, pages 3044–3058 (2021)Cite this article

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Abstract

In the past decade, the available treatments for patients with acute lymphoblastic leukemia (ALL) have rapidly expanded, in parallel with an increased understanding of the genomic features that impact the disease biology and clinical outcomes. With the development of the anti-CD22 antibody-drug conjugate inotuzumab ozogamicin, the CD3-CD19 bispecific T-cell engager antibody blinatumomab, CD19 chimeric antigen receptor T-cell therapy, and the potent BCR-ABL1 tyrosine kinase inhibitor ponatinib, the outlook of ALL in both younger and older adults has substantially improved. The availability of highly effective drugs raised important questions concerning the optimal combination and sequence of these agents, their incorporation into frontline regimens, and the role of hematopoietic stem cell transplantation. In this review, we discuss the rapidly evolving paradigms in the treatment of ALL, highlighting both established and effective regimens, as well as promising new therapies that are being evaluated in ongoing clinical trials. We specifically focus on novel combination regimens in both the frontline and salvage settings that are leading to new standards of care in the treatment of ALL.

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Acknowledgements

Supported by an MD Anderson Cancer Center Support Grant (CA016672) and SPORE. NJS is supported by the K12 Paul Calabresi Clinical Oncology Scholar Award and the American Society of Hematology Junior Faculty Scholar Award in Clinical Research.

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  1. Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Nicholas J. Short, Hagop Kantarjian & Elias Jabbour

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NJS has served as a consultant for Takeda Oncology and AstraZeneca, reports receiving research grants from Takeda Oncology and Astellas Pharma Inc., and has received honoraria from Amgen. EJ has research grants with Amgen, AbbVie, Spectrum, BMS, Takeda Oncology, Pfizer, and Adaptive.

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Short, N.J., Kantarjian, H. & Jabbour, E. Optimizing the treatment of acute lymphoblastic leukemia in younger and older adults: new drugs and evolving paradigms. Leukemia 35, 3044–3058 (2021). https://doi.org/10.1038/s41375-021-01277-3

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