Treating adults with acute lymphocytic leukemia: new pharmacotherapy options

Expert Opin Pharmacother. 2016 Dec;17(17):2319-2330. doi: 10.1080/14656566.2016.1250884. Epub 2016 Oct 31.

Abstract

Advances in acute lymphocytic leukemia (ALL) therapy has led to long-term survival rates in children. However, only 30%-40% of adults achieve long-term disease-free survival. After relapse, the outcome of salvage chemotherapy is very disappointing with less than 10% of long survival. Novel agents are therefore desperately required to improve response rates and survival, but also the quality of life of patients. Areas covered: The following review is a comprehensive summary of various novel options reported over the past few years in the therapeutic area of adult ALL. Expert opinion: Identifying key components involved in disease pathogenesis may lead to new approaches. In a near future, the incorporation of monoclonal antibodies and T-cell directed approaches including blinatumomab and chimeric antigen receptor T cells may increase the cure rates and may reduce the need for intensive therapy.

Keywords: Acute lymphoblastic leukemia; monoclonal antibodies; prognosis; targeted therapy; treatment.

Publication types

  • Review

MeSH terms

  • Adenine Nucleotides / administration & dosage
  • Adenine Nucleotides / therapeutic use*
  • Adult
  • Antibodies, Monoclonal / administration & dosage
  • Antibodies, Monoclonal / therapeutic use
  • Antineoplastic Agents / administration & dosage
  • Antineoplastic Agents / therapeutic use*
  • Arabinonucleosides / administration & dosage
  • Arabinonucleosides / therapeutic use*
  • Clofarabine
  • Disease-Free Survival
  • Drug Discovery*
  • Humans
  • Molecular Targeted Therapy
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / drug therapy*
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / metabolism
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / mortality
  • Purine Nucleosides / administration & dosage
  • Purine Nucleosides / therapeutic use*
  • Pyrimidinones / administration & dosage
  • Pyrimidinones / therapeutic use*
  • Quality of Life
  • Recurrence
  • Salvage Therapy / methods*

Substances

  • Adenine Nucleotides
  • Antibodies, Monoclonal
  • Antineoplastic Agents
  • Arabinonucleosides
  • Purine Nucleosides
  • Pyrimidinones
  • forodesine
  • Clofarabine