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Should immunologic strategies be incorporated into frontline ALL therapy?
Cecilie Utke Rank1, Wendy Stock1
1Pediatric Oncology Research Laboratory and Department of Hematology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; Department of Medicine, University of Chicago Medicine, Knapp Center for Biomedical Discovery, 900 E. 57th Street, 8th Floor Chicago, IL 60637, USA.
Best Practice & Research. Clinical Haematology
|November 24, 2018
Summary
Immunotherapy offers new targeted treatments for adult acute lymphoblastic leukemia (ALL). Novel antibody therapies show promise in improving survival and reducing toxicity, especially for older patients.
Area of Science:
- Hematology
- Immunology
- Oncology
Background:
- Adult acute lymphoblastic leukemia (ALL) survival has improved, with pediatric-inspired protocols for younger adults.
- Older ALL patients require different strategies due to chemotherapy toxicities.
- Immunotherapy presents new targeted treatment opportunities for ALL subtypes.
Purpose of the Study:
- To review new immunotherapeutic treatment options and strategies for frontline treatment of adult ALL.
- To discuss the potential of novel antibody therapies and CAR T-cells in improving survival and reducing toxicity.
- To explore targeted approaches for both B-cell and T-cell ALL.
Main Methods:
- Review of current literature on immunotherapies for adult ALL.
- Analysis of antibody therapies targeting CD19, CD22, and CD38.
- Discussion of chimeric antigen receptor T-cell therapy for relapsed B-cell ALL.
Main Results:
- CD19 and CD22 targeting show remarkable single-agent activity in relapsed ALL.
- Studies are evaluating CD19 and CD22 targeted agents in combination with chemotherapy for frontline treatment.
- Immunotherapy aims to improve event-free and overall survival by eradicating minimal residual disease and reducing chemotherapy toxicity.
Conclusions:
- Immunotherapy represents a significant advancement in adult ALL treatment.
- Targeted antibody therapies and CAR T-cells offer improved efficacy and reduced toxicity.
- Future strategies focus on combining these novel agents for optimal frontline treatment outcomes.
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