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Treatment of Older Patients with Acute Lymphoblastic Leukaemia

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Abstract

The outcome of adult acute lymphoblastic leukaemia (ALL) has improved significantly during the past decade, mainly due to intensive paediatric-based chemotherapy. Less improvement has been observed in older patients. A significantly lower rate of complete remissions, higher early mortality, higher relapse rate and poorer survival is observed in older compared with younger ALL patients. Most importantly, intensive chemotherapy with or without stem-cell transplantation is less well tolerated in older patients. In addition, there is an increasing incidence of poor prognostic factors with increasing age. Progress has been made with the development of age-adapted, moderately intensive chemotherapy protocols for Ph/BCR-ABL-negative ALL and combinations of tyrosine kinase inhibitors with chemotherapy in Ph/BCR-ABL-positive ALL. Future progress can be expected from new targeted therapies, particularly novel immunotherapies, moderately intensified consolidation strategies and reduced intensity stem-cell transplantation. For this purpose, prospective clinical trials for older patients are urgently needed.

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  1. Department of Medicine II, Goethe University Hospital, Theodor Stern Kai 7, 60590, Frankfurt, Germany

    Nicola Gökbuget

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NG has received research grants and honoraria for consultancy or speaker activities from AMGEN, Pfizer, Jazz, GileadSciences, Sigma Tau, Baxalta and Novartis.

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Gökbuget, N. Treatment of Older Patients with Acute Lymphoblastic Leukaemia. Drugs Aging 35, 11–26 (2018). https://doi.org/10.1007/s40266-017-0503-5

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