The treatment outcomes for adult Philadelphia chromosome-negative acute lymphoblastic leukemia (ALL) have improved with the introduction of pediatric protocols. On assessing long-term survivors of chemotherapy who underwent allogeneic hematopoietic stem cell transplantation (allo-HSCT), it was found that these patients had good performance status and few complications. Therefore, in the first complete remission (1CR) of ALL, allo-HSCT is indicated for patients in whom the results of chemotherapy are predicted to be poor. In adolescent and young adult (AYA) patients with ALL, allo-HSCT is recommended in the 1CR if end of consolidation measurable residual disease (MRD) is positive. In adults with ALL (non-AYA patients), if end of induction MRD is negative, chemotherapy should be continued and allo-HSCT is not recommended. In the future, it is necessary to perform a comprehensive evaluation of individual patients that considers MRD, as well as the initial tumor burden and biological features of leukemic cells.
Keyphrases
- acute lymphoblastic leukemia
- end stage renal disease
- allogeneic hematopoietic stem cell transplantation
- chronic kidney disease
- newly diagnosed
- ejection fraction
- young adults
- acute myeloid leukemia
- peritoneal dialysis
- prognostic factors
- squamous cell carcinoma
- mental health
- cell death
- rheumatoid arthritis
- dna methylation
- risk factors
- patient reported outcomes
- signaling pathway
- patient reported
- induced apoptosis
- current status