Acute Lymphoblastic Leukemia

Abstract

Overview Acute lymphoblastic leukemia (ALL) is characterized by clonal proliferation of lymphoid progenitors. In the last decade, significant advances in understanding the disease pathogenesis, refining prognostic groups, and developing novel therapies that target specific subsets, have improved our treatment strategies and patient outcomes. Therapies targeting either specific transcripts (e.g., BCR‐ABL1 tyrosine kinase inhibitors) or specific leukemic cell surface antigens (e.g., CD20, CD22, and CD19 monoclonal antibodies, chimeric antigen receptor T‐cell therapies) produced major therapeutic breakthroughs. These novel therapies and combinations are transforming our strategies for adults with ALL and are resulting in significant improvements in survival. Many of these approaches focus on decreasing or eliminating the role of chemotherapy, with the goal of making these regimens more tolerable in older adults and decreasing the morbidity and mortality associated with myelosuppression‐related infections and other complications of intensive chemotherapy.