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Comprehensive Protocol to Sample and Process Bone Marrow for Measuring Measurable Residual Disease and Leukemic Stem Cells in Acute Myeloid Leukemia
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Relapsed Acute Lymphoblastic Leukemia.

Jasmeet Sidhu1,2,3, Manash Pratim Gogoi2, Shekhar Krishnan1,2,4

  • 1Department of Pediatric Hematology and Oncology, Tata Medical Center, Kolkata, 700160, India.

Indian Journal of Pediatrics
|June 21, 2023
PubMed
Summary
This summary is machine-generated.

Outcomes for childhood acute lymphoblastic leukemia (ALL) have improved, but relapsed ALL remains a significant challenge with static survival rates. New immunotherapies, cellular therapies, and precision oncology strategies are crucial for improving outcomes in relapsed ALL.

Keywords:
ChemotherapyChildhood ALLRelapseTransplant

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Area of Science:

  • Pediatric Oncology
  • Hematology
  • Cancer Therapeutics

Background:

  • Childhood acute lymphoblastic leukemia (ALL) survival rates exceed 85% globally.
  • Outcomes for relapsed ALL remain poor at approximately 50%, contributing significantly to childhood cancer mortality.
  • Early bone marrow relapse within 18 months portends a particularly poor prognosis.

Purpose of the Study:

  • To highlight the persistent challenges in treating relapsed acute lymphoblastic leukemia (ALL).
  • To emphasize the need for improved biological understanding of relapse and drug resistance mechanisms.
  • To discuss the integration of novel therapeutic options and precision oncology strategies in relapsed ALL management.

Main Methods:

  • Review of current treatment mainstays: chemotherapy, radiotherapy, and hematopoietic stem cell transplantation (HSCT).
  • Exploration of emerging therapeutic options including immunotherapies and cellular therapies for relapsed ALL.
  • Discussion of integrated precision oncology approaches for personalized treatment strategies.

Main Results:

  • Despite overall improvements in ALL treatment, outcomes for relapsed cases have not significantly advanced.
  • Newer strategies like immunotherapies and cellular therapies offer potential for improved outcomes.
  • Precision oncology is increasingly utilized to tailor treatments for individual patients, particularly those with refractory disease.

Conclusions:

  • There is a critical need for enhanced biological insights into ALL relapse and drug resistance.
  • Innovative treatment strategies and global collaborations are essential to improve survival in relapsed ALL.
  • Understanding the optimal application of novel therapies and precision medicine is imperative for advancing care in relapsed ALL.