دورية أكاديمية
Practical guidance for the management of acute lymphoblastic leukemia in the adolescent and young adult population
| العنوان: | Practical guidance for the management of acute lymphoblastic leukemia in the adolescent and young adult population |
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| المؤلفون: | Francesca Carobolante, Sabina Chiaretti, Cristina Skert, Renato Bassan |
| المصدر: | Therapeutic Advances in Hematology, Vol 11 (2020) |
| بيانات النشر: | SAGE Publishing, 2020. |
| سنة النشر: | 2020 |
| المجموعة: | LCC:Diseases of the blood and blood-forming organs |
| مصطلحات موضوعية: | Diseases of the blood and blood-forming organs, RC633-647.5 |
| الوصف: | The outstanding therapeutic progress achieved with modern pediatric regimens in childhood acute lymphoblastic leukemia (ALL) led efforts to explore whether a similar treatment approach could be equally effective and safe in older patients, starting initially with older adolescents and young adults (AYA), variably defined in different studies by an age between 15–18 and 25–39 years. Several comparative and noncomparative trials of this type have been carried out during the last two decades, enrolling thousands of patients. Almost without exception, the new strategy improved patients’ outcomes compared with traditional adult treatments in B-lineage and T-lineage Philadelphia (Ph) chromosome-negative B-ALL, while the use of tyrosine kinase inhibitors (TKI) led to comparative progress in Ph+ ALL, a former high-risk subset more typically observed in older age groups. At present, highly effective pediatric-based regimens warrant 5-year survival rates of 60–70% in AYA patients. In view of these data, the same approach was progressively extended to older patients, improving the results up to 55 years of age. Issues of treatment compliance and drug-related toxicity have thus far prevented a comparable therapeutic advancement in patients aged >55 years. This critical review updates and summarizes with pertinent examples this global, positive therapeutic change, and examines how to promote further progress with new targeted therapies that include novel immuno-therapeutics and other agents developed against the many molecular dysfunctions detectable in various ALL subsets. Substantial progress is expected to occur soon, bringing AYA survival figures very close to that of children, and also to improve the outcome of ALL at all ages. |
| نوع الوثيقة: | article |
| وصف الملف: | electronic resource |
| اللغة: | English |
| تدمد: | 2040-6215 20406207 |
| Relation: | https://doaj.org/toc/2040-6215 |
| DOI: | 10.1177/2040620720903531 |
| URL الوصول: | https://doaj.org/article/3f7faf5095c84b2b8b3eaadc4fdaf5e3 |
| رقم الأكسشن: | edsdoj.3f7faf5095c84b2b8b3eaadc4fdaf5e3 |
| قاعدة البيانات: | Directory of Open Access Journals |
Full Text Finder | تدمد: | 20406215 20406207 |
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| DOI: | 10.1177/2040620720903531 |