Therapy of Philadelphia chromosome-negative acute lymphoblastic leukemia in adults: New paradigms

Research output: Contribution to journalReview articlepeer-review


Although the outcomes for adults with acute lymphoblastic leukemia (ALL) lag behind the stunningly successful results seen in children, new paradigms and new discoveries bring hope that this disparity will steadily lessen. The adoption of the use of pediatric intensity-type regimens in adolescents and young adults show promise in improving outcomes in this population. Recent donor-versus-no-donor comparisons in the allogeneic transplant setting highlight a potent graft-versusleukemia effect in ALL, and the application of reduced intensity conditioning transplants may exploit this effect while reducing nonrelapse mortality. New therapeutic targets, such as CD22 in precusor B-cell ALL and mutations in NOTCH1 in T-cell ALL, are being exploited in clinical trials. Finally, use of molecular techniques and flow cytometry to quantitate minimal residual disease will allow further stratifications of patients by risk, identification of new therapeutic targets and will lessen drug toxicity through the use of pharmacogenomics.

Original languageEnglish (US)
Pages (from-to)1039-1050
Number of pages12
JournalFuture Oncology
Issue number7
StatePublished - 2009


  • Acute lymphoblastic leukemia
  • Adolescents
  • Blood and marrow transplantation
  • Graft-versus-leukemia effect
  • Minimal residual disease
  • Pharmacogenomics

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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