Acute leukemia in adolescents and young adults

Both acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML) are common malignant diseases in adolescents and young adults (AYAs). Recent advances in genomic studies have helped us understand the biological nature of acute leukemia in AYAs; higher frequency of Ph-like ALL and rearrangements in DUX4, ERG, MEF2D, and ZNF384 genes in AYAs with ALL and higher frequency of FLT3-ITD, NPM1, IDH1/2, DNMT3A, ASXL1, TET2, and CEBPA mutations in AYAs with AML than that in children. The pediatric-inspired regimen has become a standard treatment approach for AYAs with ALL, but optimal treatment strategy for AYAs with AML is not yet established to date. In general, poor adherence to the pediatric-inspired regimen, whether for ALL or AML, because of toxicities is still an issue in AYAs. In addition to optimizing appropriate chemotherapies for acute leukemia in AYAs, the development of novel therapy based on genomic analyses should be explored by close cooperation between pediatric hematologists/oncologists and adult hematologists.