[Current therapeutic strategies in acute lymphoblastic leukemia in the adult]

This comprehensive overview on the most recent developments in treatments of adult acute lymphoblastic leukemia (ALL) discuss the controversies in the management of adult ALL in relation with its different phases of therapy, give an overview of current chemotherapy and stem cell transplantation approaches. Treatment strategies in adult ALL have resulted in the achievement of complete remission rates of about 80%, and long-term disease survival in about 30% of patients. However, the disease appears very heterogeneous and therapeutic strategies are now applied to adults according to groups of ALL with different prognoses. Features of poor outcome (older age, hyperleukocytosis, non-T-cell immunophenotype, Philadelphia chromosome-positive karyotype, longer time to achieve complete remission) were found in about 75% of adult ALL. This review of the literature summarized then data regarding prognostic factors involved in the determination of risk-adapted strategies. New treatment options, needed to be developed to further improve on the therapeutic perspectives for adult patients with ALL, and therapeutic schedules of main cooperative groups are also reviewed.