Adolescents and Young Adults with Acute Lymphoblastic Leukemia

Abstract

During the last decade, increasing attention has been paid to a unique group of patients with acute lymphoblastic leukemia (ALL) who lie at the crossroad of therapeutic care by pediatric and adult hematologists/oncologists. ALL is a disease that affects infants, children, adolescents, and adult patients. With current therapies, the vast majority of children with ALL are now long-term survivors; unfortunately, the same good results have not yet been obtained for adults with ALL. This review will describe current controversies surrounding the treatment of adolescents and young adults with ALL-a group who finds themselves in the transition from "pediatric" to "adult" treatment approaches. The review focuses on recent insights into disease biology, prognostic factors, and treatment outcomes that have led to a series of prospective clinical trials specifically designed for adolescents and younger adults (AYAs) with ALL. These trials have been designed to provide important new clinical, psychosocial, and biological insights, and to further improve the survival of this challenging and unique group of patients.

Acute Lymphoblastic Leukemia in Adolescents and Young Adults

“…However, it is of note that these studies have mainly focused on patients aged 15-21 years, but few have evaluated the results in young adults up to 30 years or more, in whom the frequency of adverse prognostic factors is progressively increasing. The reasons for the better results of pediatric protocols are multiple (Stock 2010). The first and probably the most important reason lay in the protocol itself.…”

Leucemia linfoblástica aguda estirpe B Philadelphia negativa en adolescentes y adultos jóvenes: Resultados del Protocolo Terapéutico LLA 15-30, Programa Nacional de Cáncer del Adulto (PANDA), Ministerio de Salud, Chile

“…5 Hematóloga Panda Hospital gustavo Fricke. 6 Hematóloga Panda Hospital san Juan de dios. 7 Hematólogo Panda Hospital sótero del río.…”

“…Este grupo de pacientes es clasificado de alto riesgo en grupos pediátricos, recibiendo esquemas de quimioterapia intensificados, con un mayor cumplimiento y adherencia. Más recientemente el uso de esquemas intensificados utilizados en pacientes adultos entre 15 y 45 años muestran una mejoría en la sobrevida global (SG), 62% a 5 años [6][7][8][9][10][11] . El Programa Nacional de Cáncer del Adulto (PANDA) ha incorporado diferentes protocolos para el tratamiento de la LLA, desde su inicio en 1988.…”

The role of HLA-matched unrelated transplantation in adult patients with Ph chromosome-negative ALL in first remission. A decision analysis

“…17 In addition, patients aged less than 21 years were excluded from this analysis because the outcome of treatment in these patients has also improved greatly using intensified chemotherapy based on a pediatric regimen. 18 …”