Treatment of acute lymphoblastic leukaemia: A new era

Effrosyni Apostolidou, Ronan T Swords, Yesid Alvarado, Francis J. Giles

Research output: Contribution to journalArticle

42 Citations (Scopus)

Abstract

Acute lymphocytic leukaemia (ALL) is a heterogeneous group of disorders that result from the clonal proliferation and expansion of malignant lymphoid cells in the bone marrow, blood and other organs. Distinct clinicopathological ALL entities have been identified, resulting in the adoption of risk-oriented treatment approaches. Advances in ALL therapy have led to long-term survival rates of >80% in children. However, only ≈30-40% of adults achieve long-term disease-free survival. Contemporary ALL treatment programmes include induction, intensified consolidation, maintenance phases and CNS prophylaxis. The optimal treatment of Philadelphia chromosome-positive patients requires the addition of BCR-ABL tyrosine kinase inhibitors, such as imatinib, whereas allogeneic stem-cell transplantation remains the preferred approach for high-risk patients in first remission. Since only ≈38% of adult ALL patients are free of disease 5 years after diagnosis and the outcome of salvage chemotherapy is very poor (complete remission rates of 20-30%, median survival of 3-6 months), novel agents are desperately required. Of those currently in clinical studies, the outlook for sphingosomal vincristine, pegylated asparaginase (pegaspargase), liposomal annamycin, ABT-751, pemetrexed, talotrexin, nelarabine and the novel BCR-ABL kinase inhibitors is discussed.

Original languageEnglish
Pages (from-to)2153-2171
Number of pages19
JournalDrugs
Volume67
Issue number15
StatePublished - Oct 16 2007
Externally publishedYes

Fingerprint

Precursor Cell Lymphoblastic Leukemia-Lymphoma
Pemetrexed
Asparaginase
Salvaging
Chemotherapy
Vincristine
Chromosomes
Stem cells
Consolidation
Protein-Tyrosine Kinases
Bone
Blood
Phosphotransferases
Therapeutics
Philadelphia Chromosome
Stem Cell Transplantation
Disease-Free Survival
Survival Rate
Bone Marrow
Maintenance

Keywords

  • ABT 751, therapeutic use
  • Acute lymphoblastic leukaemia, treatment
  • Annamycin, therapeutic use
  • Dasatinib, therapeutic use
  • Nelarabine, therapeutic use
  • Nilotinib, therapeutic use
  • Pegaspargase, therapeutic use
  • Pemetrexed, therapeutic use

ASJC Scopus subject areas

  • Toxicology
  • Health, Toxicology and Mutagenesis

Cite this

Apostolidou, E., Swords, R. T., Alvarado, Y., & Giles, F. J. (2007). Treatment of acute lymphoblastic leukaemia: A new era. Drugs, 67(15), 2153-2171.

Treatment of acute lymphoblastic leukaemia : A new era. / Apostolidou, Effrosyni; Swords, Ronan T; Alvarado, Yesid; Giles, Francis J.

In: Drugs, Vol. 67, No. 15, 16.10.2007, p. 2153-2171.

Research output: Contribution to journalArticle

Apostolidou, E, Swords, RT, Alvarado, Y & Giles, FJ 2007, 'Treatment of acute lymphoblastic leukaemia: A new era', Drugs, vol. 67, no. 15, pp. 2153-2171.
Apostolidou E, Swords RT, Alvarado Y, Giles FJ. Treatment of acute lymphoblastic leukaemia: A new era. Drugs. 2007 Oct 16;67(15):2153-2171.
Apostolidou, Effrosyni ; Swords, Ronan T ; Alvarado, Yesid ; Giles, Francis J. / Treatment of acute lymphoblastic leukaemia : A new era. In: Drugs. 2007 ; Vol. 67, No. 15. pp. 2153-2171.
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