Is allogeneic hematopoietic stem cell transplantation still the first-line therapy after the first remission in adult patients with Philadelphia chromosome-negative acute lymphoblastic leukemia? / 白血病·淋巴瘤

ABSTRACT

Whether allogeneic hematopoietic stem cell transplantation (allo-HSCT) is the optimal treatment for adult patients with Philadelphia chromosome-negative acute lymphoblastic leukemia (Ph - ALL) after the first complete remission (CR1) or not is still a controversial issue. Many studies have recently reported that adolescents and young adults with Ph- ALL may benefit from pediatric chemotherapy. Conventional baseline risk factors cannot satisfactorily predict prognosis, conversely, the early minimal residual disease (MRD) is the best stratification tool to offer different treatments for patients with different MRD status. Novel therapies, such as CAR-T cells and blinatumomab, have shown promising results in relapsed/refractory patients. Through comprehensive application of pediatric chemotherapy protocols, MRD driven strategy and novel therapies, it is hopeful to change the paradigm of how to treat adults with Ph - ALL in the future, and to bring improved outcomes and decreased adverse events.