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Hematology Reports
Volume 6
Issue 3
10.4081/hr.2014.5554
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Review

Rationale for a Pediatric-Inspired Approach in the Adolescent and Young Adult Population with Acute Lymphoblastic Leukemia, with a Focus on Asparaginase Treatment

by
Carmelo Rizzari
1,*,
Maria Caterina Putti
2,
Antonella Colombini
1,
Sara Casagranda
1,
Giulia Maria Ferrari
1,
Cristina Papayannidis
3,
Ilaria Iacobucci
3,
Maria Chiara Abbenante
3,
Chiara Sartor
3 and
Giovanni Martinelli
3
1
Pediatric Hematology-Oncology Unit, Department of Pediatrics, University of Milan-Bicocca, Via Pergolesi 33, 20900 Monza, Italy
2
Pediatric Onco-Hematology Unit, Clinic of Pediatrics, Padua, Italy
3
Institute of Hematology, University of Bologna, Bologna, Italy
*
Author to whom correspondence should be addressed.
Hematol. Rep. 2014, 6(3), 5554; https://doi.org/10.4081/hr.2014.5554
Submission received: 15 July 2014 / Revised: 21 August 2014 / Accepted: 25 August 2014 / Published: 30 September 2014

Abstract

In the last two decades great improvements have been made in the treatment of childhood acute lymphoblastic leukemia, with 5-year overall survival rates currently approaching almost 90%. In comparison, results reported in adolescents and young adults (AYAs) are relatively poor. In adults, results have improved, but are still lagging behind those obtained in children. Possible reasons for this different pattern of results include an increased incidence of unfavorable and a decreased incidence of favorable cytogenetic abnormalities in AYAs compared with children. Furthermore, in AYAs less intensive treatments (especially lower cumulative doses of drugs such as asparaginase, corticosteroids and methotrexate) and longer gaps between courses of chemotherapy are planned compared to those in children. However, although favorable results obtained in AYAs receiving pediatric protocols have been consistently reported in several international collaborative trials, physicians must also be aware of the specific toxicity pattern associated with increased success in AYAs, since an excess of toxicity may compromise overall treatment schedule intensity. Cooperative efforts between pediatric and adult hematologists in designing specific protocols for AYAs are warranted.
Keywords: asparaginase; acute lymphoblastic leukemia; adolescent; young adult asparaginase; acute lymphoblastic leukemia; adolescent; young adult

Share and Cite

MDPI and ACS Style

Rizzari, C.; Putti, M.C.; Colombini, A.; Casagranda, S.; Ferrari, G.M.; Papayannidis, C.; Iacobucci, I.; Abbenante, M.C.; Sartor, C.; Martinelli, G. Rationale for a Pediatric-Inspired Approach in the Adolescent and Young Adult Population with Acute Lymphoblastic Leukemia, with a Focus on Asparaginase Treatment. Hematol. Rep. 2014, 6, 5554. https://doi.org/10.4081/hr.2014.5554

AMA Style

Rizzari C, Putti MC, Colombini A, Casagranda S, Ferrari GM, Papayannidis C, Iacobucci I, Abbenante MC, Sartor C, Martinelli G. Rationale for a Pediatric-Inspired Approach in the Adolescent and Young Adult Population with Acute Lymphoblastic Leukemia, with a Focus on Asparaginase Treatment. Hematology Reports. 2014; 6(3):5554. https://doi.org/10.4081/hr.2014.5554

Chicago/Turabian Style

Rizzari, Carmelo, Maria Caterina Putti, Antonella Colombini, Sara Casagranda, Giulia Maria Ferrari, Cristina Papayannidis, Ilaria Iacobucci, Maria Chiara Abbenante, Chiara Sartor, and Giovanni Martinelli. 2014. "Rationale for a Pediatric-Inspired Approach in the Adolescent and Young Adult Population with Acute Lymphoblastic Leukemia, with a Focus on Asparaginase Treatment" Hematology Reports 6, no. 3: 5554. https://doi.org/10.4081/hr.2014.5554

APA Style

Rizzari, C., Putti, M. C., Colombini, A., Casagranda, S., Ferrari, G. M., Papayannidis, C., Iacobucci, I., Abbenante, M. C., Sartor, C., & Martinelli, G. (2014). Rationale for a Pediatric-Inspired Approach in the Adolescent and Young Adult Population with Acute Lymphoblastic Leukemia, with a Focus on Asparaginase Treatment. Hematology Reports, 6(3), 5554. https://doi.org/10.4081/hr.2014.5554

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