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Molecular Therapies

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Book cover Adult Acute Lymphocytic Leukemia

Part of the book series: Contemporary Hematology ((CH))

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Abstract

Unfortunately the advances made in the management of pediatric acute lymphoblastic leukemia (ALL) have not been matched in adult ALL. Only 30–40% of adult patients with ALL will achieve long-term disease-free survival with current agents and regimens, despite very high (∼90%) initial complete response (CR) rates [1, 2]. Most patients will relapse within 12–24 months of their initial CR; many relapse while they are still receiving maintenance therapy [1, 3, 4]. Salvage regimens offer CR rates of ∼30% or higher, but disease-free intervals are brief [5]. Five year overall survival following relapse is a dismal ∼7% with currently available strategies [6]. Though allogeneic stem cell transplantation improves long term survival, graft-versus-leukemia effects are relatively modest [1–3]. This is illustrated by two lines of evidence: (1) a report from the International Bone Marrow Transplant Registry, which found similar relapse rates in matched sibling and syngeneic transplants and (2) reports detailing the lack of efficacy of donor lymphocyte infusions for relapsed ALL after allogeneic transplantation [2, 4]. There is clearly a need for novel agents and combinations of agents in the management of adult ALL across all phases of disease.

An erratum to this chapter can be found at http://dx.doi.org/10.1007/978-1-60761-707-5_24

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  1. Section of Leukemia and Bone Marrow Transplantation, Division of Oncology, Washington University in Saint Louis, 660 South Euclid, Saint Louis, MO, USA, 63110

    Camille N. Abboud

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    Anjali S. Advani

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    Hillard M. Lazarus

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Abboud, C.N. (2011). Molecular Therapies. In: Advani, A., Lazarus, H. (eds) Adult Acute Lymphocytic Leukemia. Contemporary Hematology. Humana Press. https://doi.org/10.1007/978-1-60761-707-5_16

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