Dr. Elias Jabbour, an Associate Editor of Blood Cancers Today, discusses the burning questions in acute lymphoblastic leukemia (ALL). Topics include approaches to treating Philadelphia-negative ALL, measuring MR-D in pH negative disease, treatment options for both younger and older patients with pH negative leukemia, and current treatment options for relapsed disease in ALL.
Combining targeted therapies and low-dose chemotherapy has significantly improved survival rates in younger patients with Philadelphia-negative acute lymphoblastic leukemia (ALL).
New treatment approaches including low-dose chemotherapy and immune therapies have shown promising results in improving outcomes for older patients with Philadelphia-negative ALL.
Deep dives
Advancements in Treatment of PH-Negative ALL for Younger Patients
In the podcast, the speaker discusses the advancements in the treatment of Philadelphia-negative acute lymphoblastic leukemia (ALL) for younger patients. They highlight the use of targeted therapies, including TKIs and immunotherapy, in combination with low-dose chemotherapy. This approach has shown significant improvements in survival rates, with four-year survival reaching 82%. The speaker also emphasizes the importance of measuring minimal residual disease (MRD) using flow cytometry and NGS to assess disease response, guiding treatment decisions. They mention ongoing studies to further explore the role of immunotherapy upfront and reduce chemotherapy in the management of ALL.
Innovative Treatment Approaches for Older PH-Negative ALL Patients
The podcast delves into the challenges of treating older patients with Philadelphia-negative acute lymphoblastic leukemia (ALL) and highlights the promising results of new treatment approaches. The speaker discusses the use of low-dose chemotherapy combined with immune therapies like blinatumomab, resulting in a five-year survival rate of 50%. Importantly, they mention a chemo-free approach using immune therapy alone for older patients with certain risk factors or immunochemical disorders, leading to an 80% survival rate. The speaker acknowledges the need for longer follow-up to solidify these findings, but the results so far show significant progress in improving outcomes for older PH-negative ALL patients.
Unanswered Questions and Future Directions for ALL Research
The podcast concludes by addressing the top three unanswered questions or burning questions in acute lymphoblastic leukemia (ALL) research. The first question revolves around preventing CNS relapses, specifically exploring the role of chemotherapy versus intrathecal or systemic chemotherapy. The second question centers on whether it is possible to move away from chemotherapy and replace it with targeted therapies or immunotherapies in not only PH-negative ALL but other leukemias as well. The third question focuses on reducing the reliance on allogeneic transplants and exploring the potential of CAR-T cell therapy or other novel therapies for relapsed ALL. The speaker emphasizes the ongoing efforts to improve ALL treatment, providing hope for better outcomes and a potential future without the need for extensive chemotherapy or transplants.
Elias Jabbour, MD, of the University of MD Anderson Cancer Center stops by The HemOnc Pulse for a live show at the Eleventh Annual Meeting of the Society of Hematologic Oncology in Houston, Texas.
In this episode, Dr. Jabbour, who is also an Associate Editor of Blood Cancers Today, the home of The HemOnc Pulse, discusses the most burning questions in acute lymphoblastic leukemia (ALL).
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