Adult Acute Lymphoblastic Leukemia

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Therapy".

Deadline for manuscript submissions: closed (31 December 2022) | Viewed by 10492

Special Issue Editor


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Guest Editor
Department of Hematology, Lyon-Sud Hospital, Hospices Civils de Lyon, 69495 Pierre Bénite, France
Interests: Acute leukemia; hematopoietic stem cell transplantation; myelodysplastic syndromes; targeted therapy.
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Special Issue Information

Dear colleagues:

Unlike childhood acute lymphoblastic leukemia (ALL), adult ALL has historically had a dismal prognosis, with limited treatment options and cure rates less than 40%. However, over the last several decades, major advances in our understanding of the disease pathophysiology and genomics have led to better disease stratification and prognostication, which have improved the patient outcome. The development of intensified chemotherapy protocols has substantially improved the outcome of younger adults, with the goal of recapitulating the success observed in the pediatric population. Nevertheless, the outcome of older adults and patients with relapsed or refractory ALL remain poor. More recently, the concept of measurable residual disease (MRD) has become a standard of care in stratifying patients and in guiding treatment decisions, and the development of new diagnostic platforms such as next-generation sequencing (NGS) has introduced significant advances in the sensitivity of MRD diagnostics. Concomitantly, the treatment of ALL has been revolutionized with the advent of tyrosine kinase inhibitors (TKIs) in Philadelphia chromosome-positive ALL, and is currently moving forward in B-cell lineage ALL with the development of monoclonal antibodies targeting CD20, antibody-drug conjugates targeting CD22, bispecific antibodies, and CD19 chimeric antigen receptor T-cell therapy. Over the coming years, these new immunotherapeutic agents should deeply change the therapeutic strategies for adult ALL patients.

This Special Issue dedicated to adult ALL will highlight the current state of the art in this disease, with future prospects for improving therapies, and will recall the constant progresses made over the past years in the disease pathophysiology thanks to the advances in molecular biology, and in its treatment, with the development of immunotherapy.

Dr. Xavier Thomas
Guest Editor

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Keywords

  • acute lymphoblastic leukemia
  • adult ALL
  • molecular biology
  • treatment
  • immunotherapy

Published Papers (2 papers)

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Research

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13 pages, 7988 KiB  
Article
Impact of Blinatumomab Treatment on Bone Marrow Function in Patients with Relapsed/Refractory B-Cell Precursor Acute Lymphoblastic Leukemia
by Hagop M. Kantarjian, Gerhard Zugmaier, Monika Brüggemann, Brent L. Wood, Heinz A. Horst, Yi Zeng and Giovanni Martinelli
Cancers 2021, 13(22), 5607; https://doi.org/10.3390/cancers13225607 - 9 Nov 2021
Cited by 5 | Viewed by 2702
Abstract
Association of blinatumomab treatment with myelosuppression was examined in this study. Peripheral blood counts were assessed prior to, during, and after blinatumomab treatment in patients with relapsed/refractory Philadelphia chromosome-negative (Ph−) B-cell precursor (BCP) acute lymphoblastic leukemia (ALL; n = 267) and Ph+ BCP-ALL [...] Read more.
Association of blinatumomab treatment with myelosuppression was examined in this study. Peripheral blood counts were assessed prior to, during, and after blinatumomab treatment in patients with relapsed/refractory Philadelphia chromosome-negative (Ph−) B-cell precursor (BCP) acute lymphoblastic leukemia (ALL; n = 267) and Ph+ BCP-ALL (n = 45) from the TOWER and ALCANTARA studies, respectively, or chemotherapy in patients with Ph− BCP-ALL (n = 109) from the TOWER study; all the patients with relapsed/refractory BCP-ALL and responders achieving complete remission (CR) or CR with partial/incomplete hematological recovery (CRh/CRi) were evaluated. Event-free survival (EFS) and overall survival (OS) were assessed in patients achieving CR and CRh/CRi. Median leukocyte, neutrophil, and platelet counts increased during two blinatumomab cycles but remained low longer after chemotherapy. Among the responders, there was a trend that a greater proportion of patients achieved CR with blinatumomab (Ph−, 76.5%; Ph+, 77.8%) versus with chemotherapy (Ph−, 63.6%). In the TOWER study, the survival prognosis for patients achieving CRh/CRi versus CR with blinatumomab was more similar (median OS, 11.9 (95% CI, 3.9–not estimable (NE)) vs. 15.0 (95% CI, 10.4–NE) months, p = 0.062) than with chemotherapy (5.2 (95% CI, 1.6–NE) vs. 18.9 (95% CI, 9.3–NE) months, p = 0.013). Blinatumomab treatment, with only temporary and transient myelosuppression, resulted in a greater survival benefit than chemotherapy. Full article
(This article belongs to the Special Issue Adult Acute Lymphoblastic Leukemia)
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Review

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24 pages, 415 KiB  
Review
Treatment of Philadelphia Chromosome-Positive Acute Lymphoblastic Leukemia in Adults
by Khalil Saleh, Alexis Fernandez and Florence Pasquier
Cancers 2022, 14(7), 1805; https://doi.org/10.3390/cancers14071805 - 1 Apr 2022
Cited by 14 | Viewed by 6941
Abstract
Philadelphia-chromosome positive acute lymphoblastic leukemia (Ph+ ALL) is the most common subtype of B-ALL in adults and its incidence increases with age. It is characterized by the presence of BCR-ABL oncoprotein that plays a central role in the leukemogenesis of Ph+ ALL. Ph+ [...] Read more.
Philadelphia-chromosome positive acute lymphoblastic leukemia (Ph+ ALL) is the most common subtype of B-ALL in adults and its incidence increases with age. It is characterized by the presence of BCR-ABL oncoprotein that plays a central role in the leukemogenesis of Ph+ ALL. Ph+ ALL patients traditionally had dismal prognosis and long-term survivors were only observed among patients who underwent allogeneic hematopoietic stem cell transplantation (allo-HSCT) in first complete remission (CR1). However, feasibility of allo-HSCT is limited in this elderly population. Fortunately, development of increasingly powerful tyrosine kinase inhibitors (TKIs) from the beginning of the 2000′s dramatically improved the prognosis of Ph+ ALL patients with complete response rates above 90%, deep molecular responses and prolonged survival, altogether with good tolerance. TKIs became the keystone of Ph+ ALL management and their great efficacy led to develop reduced-intensity chemotherapy backbones. Subsequent introduction of blinatumomab allowed going further with development of chemo free strategies. This review will focus on these amazing recent advances as well as novel therapeutic strategies in adult Ph+ ALL. Full article
(This article belongs to the Special Issue Adult Acute Lymphoblastic Leukemia)
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