How the treatment of ALL is changing

Robin Foà, MD from the Sapienza University, Rome, Italy discusses the advances in the diagnostics and treatment of acute lymphoblastic leukemia (ALL) at the European Hematology Association (EHA) 2016 Annual Congress in Copenhagen, Denmark. Prof. Foà first talks about changes in diagnostics and how biological stratification is becoming more sophisticated. For example, patients should be tested for Philadelphia chromosome-positive (Ph+) ALL at presentation and if tested positive, should receive a different therapy with tyrosine kinase inhibitors targeting the specific abnormality. Further, the monitoring of minimal residual disease (MRD) is now guding treatment in clinical trials, which determines decisions such as whether a patient should receive a transplant. Prof. Foà also discusses new drugs such as rituximab, which is an monoclonal anti-CD20 antibody, and blinatumomab, which is a bispecific monoclonal antibody. He also discusses the possibility of a chemotherapy-free treatment for ALL, and specifically talks about the example of Ph+ ALL. According to Prof. Foà, every Ph+ ALL patient can go into remission with an inhibitor. He further talks about an upcoming trial with ALL patients 18 or older, that will explore the use of a second-generation tyrosine kinase inhibitor and blinatumomab (NCT02744768). Finally, he discusses the potential of immunotherapy, including CAR T-cells. Prof. Foà concludes that we have entered an exciting time for ALL.

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