Significant improvements have occurred for adolescent and young adult (AYA) B-cell acute lymphoblastic leukemia (B-ALL) patients following the widespread adoption of "pediatric-inspired" treatment regimens for AYA patients cared for in adult oncology settings. However, for AYA patients, aged 15 to 39, an outcomes gap remains in B-ALL, necessitating the incorporation of novel therapies into up-front treatment regimens. As a result, clinical trial enrollment remains the current standard of care for AYA B-ALL across disease subtypes when available and accessible. Currently, several up-front trials are looking to incorporate the use of inotuzumab, blinatumomab, and chimeric antigen receptor T-cell therapy into existing chemotherapy backbones for AYA patients, as well as tyrosine kinase inhibitors for both Philadelphia-positive (Ph+) and Ph-like B-ALL. In addition to ongoing attempts to improve up-front treatments by incorporating immunotherapy and targeted approaches, the increased use of next generation sequencing for measurable residual disease evaluation has led to superior risk-stratification and a decreased need to pursue consolidative hematopoietic stem cell transplantation during the first complete remission for many patients.
Keyphrases
- end stage renal disease
- acute lymphoblastic leukemia
- newly diagnosed
- clinical trial
- healthcare
- chronic kidney disease
- randomized controlled trial
- type diabetes
- prognostic factors
- cell therapy
- adipose tissue
- squamous cell carcinoma
- acute myeloid leukemia
- mental health
- gene expression
- patient reported outcomes
- combination therapy
- bone marrow
- health insurance
- rectal cancer
- drug delivery
- genome wide
- quality improvement
- double blind
- ulcerative colitis
- electronic health record
- cell free