Vol 6, No 1 (2015)
Review paper
Published online: 2015-05-14

open access

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Advances in the treatment of adult patients with acute leukemias

Agnieszka Wierzbowska
DOI: 10.5603/Hem.2015.0015
Hematologia 2015;6(1):52-62.

Abstract

Significant progress has been made within the last years in elucidating and understanding the molecular pathogenesis of acute leukemias and for identifying factors predictive of outcome. Such achievements have thereby provided new opportunities for developing innovative and more effective drugs. There is also evidence that improving the quality of remission can reduce the risk of relapse. New and more effective induction strategies of increasing the daunorubicin dose, introducing antibody-directed chemotherapy and alternative nucleoside analogs may displace the longstanding standard 3 + 7 chemotherapy in patients aged below 60 years suffering acute myeloid leukemia (AML). An unexpected recent finding has been that complete remission in elderly AML patients may not necessarily translate into an overall survival advantage. Hypomethylating agents have demonstrated survival benefit without any improvement in remission rate. The prognosis of adults with acute lymphoblastic leukemia (ALL) is still not satisfactory and adult ALL still remains a challenging disease. Novel methodologies, including new molecular therapeutic targets, immunotherapy with monoclonal antibodies or CAR lymphocytes are very promising for improving ALL patient prognosis. This paper provides a summary review of current insights into new therapeutic strategies for acute leukemias.




Hematology in Clinical Practice