EHA Library - The official digital education library of European Hematology Association (EHA)

Progress in treatment of ALL in adults
EHA Library. Gökbuget N. 06/12/16; 136670 Topic: 3Aa B lymphoblastic leukemia/lymphoma
Disclosure(s): Goethe-Universität Frankfurt
Dr. N Gökbuget
Dr. N Gökbuget
Contributions
Learning Objectives
Kjeld Schmiegelow - Chair Introduction
The cure rates for low risk ALL (young age, B-lineage, low white blood cell count) reflect incremental successes of multi-agent chemotherapy that has built on continuously improved pharmacokinetic/-dynamic optimizations of dosing of broadly acting traditional anti-leukaemic drugs. In contrast, the outcome of many other ALL subsets have been inferior, including for patients with T-ALL, patients with poor/slow response to induction therapy, and adult patients with ALL. Modern biotechnology, implementation of sensitive minimal residual disease (MRD) monitoring, application of pediatric-inspired ALL protocols, and use of novel targeted agents have provided numerous incremental improvements for these subsets as highlighted in this session. i) Although T-ALL have specific treatment requirements, the gap to B-ALL has been closed; ii) highly sensitive MRD monitoring has become the most important treatment stratification feature; iii) and there are so far no data that support that age in itself is a risk factor (children vs adolescents vs adults) when patients are stratified by their leukemia-associated risk factors and treated by similar protocols. In addition to these achievements, genome-wide analyses (including next generation sequencing) have identified novel risk factors within host genome variants and the mutational landscape of leukemic clones. To determine the prognostic significance of many of these (i.e. effect of administered therapy) large international studies are needed.

Learning Objectives of the article
- Understand the role of coding and non-coding DNA for T-ALL pathogenesis.
- Describe the pros and cons of the various techniques for MRD monitoring.
- Describe major reasons of the difference in cure rate for pediatric and adult ALL.

Learning Objectives of the presentation
After viewing this presentation the participant will be able to:
- Discuss general management strategy for adult ALL.
- Describe current essential therapies for newly diagnosed ALL .
- Discuss risk adapted, age adapted and individualised treatment modifications.
- Describe results and potential future role of emerging new therapies.

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