The extremely aggressive tumour of lymphoblasts, which are progenitor cells of the lymphoid B-cell or T-cell lineage, is known as acute lymphoblastic leukaemia (ALL). Although it only makes about 1% of all adult cancers, it is far more common in children, accounting for around 25% of all childhood cancers. 75% of ALL instances occur in children under the age of six, with the greatest occurrence occurring between the ages of two and five. The projected number of new cases in the United States in 2008 was roughly 5,400, and 1,460 persons died of their ailment. A recent successful example of such strategy is addition of ABL-kinase inhibitors to treatment of Ph + ALL. Second, there should remain the emphasis on risk stratification of adult ALL patients and identification of those who can benefit most from allo-HSCT in order to increase cure rate in high risk patients using the powerful GvL effect and improve survival of non-high risk patients avoiding treatment related mortality. A recent large step forward in this direction is the maturation and implementation of MRD monitoring and the incorporation of MRD status into treatment decision algorithms. Monitoring of subsequent MRD has already influenced clinical outcomes in the most recent attempts. Lastly, strong reflective therapeutic approaches for use in elderly patient and successful therapeutic models tested to enhance the adult ALL general cure ratios will be designed and developed further. However, not all adults are able to tolerate such dose intensification and the exact subset of patients who are likely to benefit has not clearly been defined. Furthermore, elderly patients are particularly susceptible to the dose-limiting toxicities of these agents and are often excluded from Allo-SCT on the basis of performance status and medical comorbidities. Novel targeted therapies offer the promise of effective anti-leukemic activity with reduced toxicity from off-target effects. Given the diverse molecular and genetic alterations occurring in ALL, it is unlikely that a single agent will be effective for all patients with ALL. However, with the ability to characterize the immunophenotype and genotype of each patient’s leukemia, targeted therapy can be expected to lead to improvements in remission and survival as part of individualized treatment strategies.
| DETAILS | |
| AUTHOR'S NAME | Hadeel Abeer Rady, Qubaa Ahmed Sabry, Fadhil Adil Jassim, Hassan Majeed Mutashar, Atheer Taleb Thajeb, & Marwa Khalid Hasan |
| ISBN | 978-93-95949-94-1 |
| EDITION | First |
| BINDING | Hardbound |
| PAGES | 86 |
| PUBLISHER | Perception Publishing |
| PRICE | ISBN: Later MRP: 1495.00 INR || 100 USD The extremely aggressive tumour of lymphoblasts, which are progenitor cells of the lymphoid B-cell or T-cell lineage, is known as acute lymphoblastic leukaemia (ALL). Although it only makes about 1% of all adult cancers, it is far more common in children, accounting for around 25% of all childhood cancers. 75% of ALL instances occur in children under the age of six, with the greatest occurrence occurring between the ages of two and five. The projected number of new cases in the United States in 2008 was roughly 5,400, and 1,460 persons died of their ailment. A recent successful example of such strategy is addition of ABL-kinase inhibitors to treatment of Ph + ALL. Second, there should remain the emphasis on risk stratification of adult ALL patients and identification of those who can benefit most from allo-HSCT in order to increase cure rate in high risk patients using the powerful GvL effect and improve survival of non-high risk patients avoiding treatment related mortality. A recent large step forward in this direction is the maturation and implementation of MRD monitoring and the incorporation of MRD status into treatment decision algorithms. Monitoring of subsequent MRD has already influenced clinical outcomes in the most recent attempts. Lastly, strong reflective therapeutic approaches for use in elderly patient and successful therapeutic models tested to enhance the adult ALL general cure ratios will be designed and developed further. However, not all adults are able to tolerate such dose intensification and the exact subset of patients who are likely to benefit has not clearly been defined. Furthermore, elderly patients are particularly susceptible to the dose-limiting toxicities of these agents and are often excluded from Allo-SCT on the basis of performance status and medical comorbidities. Novel targeted therapies offer the promise of effective anti-leukemic activity with reduced toxicity from off-target effects. Given the diverse molecular and genetic alterations occurring in ALL, it is unlikely that a single agent will be effective for all patients with ALL. However, with the ability to characterize the immunophenotype and genotype of each patient’s leukemia, targeted therapy can be expected to lead to improvements in remission and survival as part of individualized treatment strategies. |