Vol 1, No 1 (2010)
Review paper
Published online: 2010-02-04
Treatment of elderly patients with acute lymphoblastic leukemia
Hematologia 2010;1(1):41-48.
Abstract
Outcome in elderly patients with acute lymphoblastic leukemia (ALL) is poor. Older age,
biological status and the presence of concomitant diseases limit the possibility to apply intensive
chemotherapy in this group of patients, and result in decreased chance to achieve and
maintain complete remission. Patients with Philadelphia-negative ALL who are candidates
for radical treatment should receive induction and consolidation therapy with reduced doses of
cytostatics, followed by either maintenance or non-myeloablative allogeneic hematopoietic stem
cell transplantation (RIC-alloHSCT). Those with Philadelphia-positive ALL should be treated
with tyrosine kinase inhibitors alone or combined with reduced dose chemotherapy, followed by
either maintenance or RIC-alloHSCT. The use of imatinib-containing protocols increases CR rates and prolongs survival. Progress in the treatment of elderly patients with ALL may depend
on introduction of novel therapeutic agents with limited organ toxicity while maintained antileukemic
activity.
Keywords: acute lymphoblastic leukemiatreatmentchemotherapyimatinibtransplantation