Advances in Supportive Care for Acute Lymphoblastic Leukemia

Cook, Joselle; Litzow, Mark R.

doi:10.1007/s11899-020-00585-2

Cited by 8 publications

(8 citation statements)

References 171 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…They address the importance of antibacterial and antifungal prophylaxis during prolonged periods of neutropenia and provide guidelines on agent selection depending on the leukemia therapy being utilized. 5,42 Our ability to optimize supportive care measurements throughout a patient's multiply relapsed disease course plays a key role in their outcomes and ability to overcome the many toxicities that come with repeat exposure to cytotoxic chemotherapy, immunotherapy, and transplant alike.…”

Section: Discussionmentioning

confidence: 99%

“…Along with emerging therapeutic options, improved supportive care has led to reduced morbidities in patients. 5 Herein, we present four patients who have benefited from these promising treatment modalities leading to repeated inductions of complete remissions (CR) and prolonged disease-free survival. Our cases illustrate that these therapeutic advances, in addition to improved supportive care, have altered the landscape of pediatric B-ALL transforming it into a chronic disease.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Have CD19-directed immunotherapy and haploidentical hematopoietic cell transplantation transformed pediatric B-cell acute lymphoblastic leukemia into a chronic disease?

2021

View full text Add to dashboard Cite

The treatment of pediatric B-cell acute lymphoblastic leukemia (B-ALL) has undergone several recent advancements, leading to an increased amount of treatment options for relapsed patients. The development of immunotherapies such as anti-CD19 chimeric antigen receptor(CAR) T cells and bispecific T-cell engagers has given clinicians therapeutic options with less expected toxicity when compared to standard re-induction chemotherapy. This is especially beneficial in patients with toxicities from their prior treatment. Along with this, the emergence of haploidentical hematopoietic cell transplantation (HCT) has increased opportunity for patients to receive HCT who may not have had an available matched donor. We present four patients who have received all of these therapies in different combinations to treat multiple relapses. Because of the success of achieving remission as well as decreasing toxicity, the patients are alive and well up to 15 y after the original B-ALL diagnosis, rendering this as a chronic disease for them.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Have CD19-directed immunotherapy and haploidentical hematopoietic cell transplantation transformed pediatric B-cell acute lymphoblastic leukemia into a chronic disease?

2021

View full text Add to dashboard Cite

show abstract

“…Irradiated/virus-inactivated blood and leuko-depleted products should be used. Patient monitoring is advised, as the likelihood of alloimmunization increases with every additional blood product ( 15 , 19 , 66 , 69 ).…”

Section: Supportive Care In Conventional Childhood All Therapymentioning

confidence: 99%

“…These novel targeted drugs show great promise but are also associated with unique and often severe toxicities and side-effects (7)(8)(9)(10)(11)(12)(13). Advanced supportive care (SC) methods could be paramount to ameliorate outcomes further, reduce side-effects, and ensure that patients derive the most benefit from ALL therapy (14,15). Considering the constant development of oncological therapies, the management of complex new side-effects implies a constant adaptation of supportive care measurements.…”

Section: Introductionmentioning

confidence: 99%

Supportive methods for childhood acute lymphoblastic leukemia then and now: A compilation for clinical practice

et al. 2022

View full text Add to dashboard Cite

Survival of childhood acute lymphoblastic leukemia has significantly improved over the past decades. In the early years of chemotherapeutic development, improvement in survival rates could be attained only by increasing the cytostatic dose, also by modulation of the frequency and combination of chemotherapeutic agents associated with severe short- and long-time side-effects and toxicity in a developing child's organism. Years later, new treatment options have yielded promising results through targeted immune and molecular drugs, especially in relapsed and refractory leukemia, and are continuously added to conventional therapy or even replace first-line treatment. Compared to conventional strategies, these new therapies have different side-effects, requiring special supportive measures. Supportive treatment includes the prevention of serious acute and sometimes life-threatening events as well as managing therapy-related long-term side-effects and preemptive treatment of complications and is thus mandatory for successful oncological therapy. Inadequate supportive therapy is still one of the main causes of treatment failure, mortality, poor quality of life, and unsatisfactory long-term outcome in children with acute lymphoblastic leukemia. But nowadays it is a challenge to find a way through the flood of supportive recommendations and guidelines that are available in the literature. Furthermore, the development of new therapies for childhood leukemia has changed the range of supportive methods and must be observed in addition to conventional recommendations. This review aims to provide a clear and recent compilation of the most important supportive methods in the field of childhood leukemia, based on conventional regimes as well as the most promising new therapeutic approaches to date.

show abstract

“…The therapeutical CTL019 construct was proven to be highly efficient in clinical trials of childhood ALL patients [ 62 , 63 ]. Therefore, molecularly engineered T cells constitute a prospective type of management in hematological malignancies [ 64 ]. However, although CART-Ts are designed according to clinically approved protocols, this therapy does not remain without flaws.…”

Section: Immunotherapymentioning

confidence: 99%

Targeted Therapy in the Treatment of Pediatric Acute Lymphoblastic Leukemia—Therapy and Toxicity Mechanisms

Lejman

Kuśmierczuk

Bednarz

et al. 2021

IJMS

View full text Add to dashboard Cite

Targeted therapy has revolutionized the treatment of poor-prognosis pediatric acute lymphoblastic leukemia (ALL) with specific genetic abnormalities. It is still being described as a new landmark therapeutic approach. The main purpose of the use of molecularly targeted drugs and immunotherapy in the treatment of ALL is to improve the treatment outcomes and reduce the doses of conventional chemotherapy, while maintaining the effectiveness of the therapy. Despite promising treatment results, there is limited clinical research on the effect of target cell therapy on the potential toxic events in children and adolescents. The recent development of highly specific molecular methods has led to an improvement in the identification of numerous unique expression profiles of acute lymphoblastic leukemia. The detection of specific genetic mutations determines patients’ risk groups, which allows for patient stratification and for an adjustment of the directed and personalized target therapies that are focused on particular molecular alteration. This review summarizes the knowledge concerning the toxicity of molecular-targeted drugs and immunotherapies applied in childhood ALL.

show abstract

Advances in Supportive Care for Acute Lymphoblastic Leukemia

Cited by 8 publications

References 171 publications

Have CD19-directed immunotherapy and haploidentical hematopoietic cell transplantation transformed pediatric B-cell acute lymphoblastic leukemia into a chronic disease?

Have CD19-directed immunotherapy and haploidentical hematopoietic cell transplantation transformed pediatric B-cell acute lymphoblastic leukemia into a chronic disease?

Supportive methods for childhood acute lymphoblastic leukemia then and now: A compilation for clinical practice

Targeted Therapy in the Treatment of Pediatric Acute Lymphoblastic Leukemia—Therapy and Toxicity Mechanisms

Contact Info

Product

Resources

About