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Updated: Feb 21, 2026
Murine Model of Leukemia Relapse to Induction Chemotherapy for Acute Lymphoblastic Leukemia
Published on: October 17, 2025
Current treatment of adult acute lymphoblastic leukemia
1Department of Hematology, Yokohama City University Medical Center.
Insights
Survival outcomes for acute lymphoblastic leukemia (ALL) have improved, especially in adults using pediatric protocols. Advances in tyrosine kinase inhibitors (TKIs) have significantly improved prognosis for Philadelphia chromosome-positive ALL.
Area of Science:
- Hematology
- Oncology
- Pediatric Oncology
Background:
- Survival rates for pediatric acute lymphoblastic leukemia (ALL) have significantly improved.
- Adolescent and young adult ALL outcomes are enhanced by pediatric-based treatment protocols.
- Adult ALL treatment increasingly mirrors pediatric approaches, with specific considerations for T-cell ALL.
Purpose of the Study:
- To review current treatment strategies for adult acute lymphoblastic leukemia (ALL).
- To discuss future perspectives and novel therapeutic developments for adult ALL.
- To highlight the challenges and progress in managing adult T-cell ALL and Philadelphia chromosome-positive ALL.
Main Methods:
- Review of current treatment strategies for adult ALL.
- Discussion of recent advancements, including nelarabine chemotherapy and tyrosine kinase inhibitors (TKIs).
- Analysis of outcomes for relapsed and refractory adult ALL.
Main Results:
- Pediatric protocols improve outcomes for adolescent and young adult ALL patients.
- Tyrosine kinase inhibitors (TKIs) have revolutionized treatment for Philadelphia chromosome-positive ALL, leading to high remission rates.
- Nelarabine-based chemotherapy shows promise in newly diagnosed adult T-cell ALL.
Conclusions:
- Adult ALL treatment benefits from pediatric protocols and targeted therapies.
- Significant progress has been made in treating Philadelphia chromosome-positive ALL with TKIs.
- Further research into novel agents is crucial for improving outcomes in relapsed and refractory adult ALL.
Abstract:
The survival outcomes for children with acute lymphoblastic leukemia (ALL) have dramatically improved over recent years, and improved outcomes in adolescents and young adults patients have been achieved by applying regimens based on pediatric protocols. The treatment strategies for adult ALL are similar to those for pediatric ALL. T-cell ALL is less common than B-cell ALL. Therefore, there are only few reports of investigations in a large group of adult T-ALL patients. In Japan, nelarabine-combined chemotherapy has been tested in a phase II study in patients with newly diagnosed T-ALL. Patients with Philadelphia chromosome-positive ALL had a poor prognosis. However, the introduction of a tyrosine kinase inhibitor (TKI) has dramatically altered treatment strategies, resulting in complete remission in virtually all patients and an increased proportion of patients who undergo allogeneic stem cell transplantation. The prognosis of adults with relapsed and refractory ALL is extremely poor, and some novel agents are currently under development for relapsed and refractory ALL. This article describes the current treatment strategy and future perspectives for adult ALL.
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