The Role of Transplants in Patients With ALL
Mark R. Litzow, MD, chair, ECOG-ACRIN Leukemia Committee, professor of medicine, Division of Hematology, Mayo Clinic, discusses the role of transplant in patients with acute lymphoblastic leukemia (ALL).
Mark R. Litzow, MD, chair, ECOG-ACRIN Leukemia Committee, professor of medicine, Division of Hematology, Mayo Clinic, discusses the role of transplant in patients with acute lymphoblastic leukemia (ALL).
Clinical Pearls:
- The advent of pediatric-intensive chemotherapy regimens has demonstrated improved outcomes in younger patients compared to traditional chemotherapy regimens
- Benefit has also been seen in patients up to 40-45 years old, but patients older than 40-45 years did not tolerate the pediatric-intensive chemotherapy regimens as well due to complications and treatment-related mortality
- Due to these results, younger patients may not need transplants in first remission but younger patients with high-risk features, such as high white blood cell count or adverse cytogenetics, may still benefit from transplant
- Outcomes are worse in older patients who undergo chemotherapy treatment, but reduced-intensity conditioning transplant regimens are in development and have demonstrated encouraging results in older patients
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