The panelists, Raoul Tibes, MD, PhD, and Bijal D. Shah, MD, explain the mechanism and therapeutic potential of CAR T-cell immunotherapy in the management of acute lymphoblastic leukemia.

What causes acute lymphocytic leukemia (ALL)?

ALL happens when there are changes in the genetic material (DNA) in bone marrow cells. The cause of these genetic changes is unknown. However, there are certain factors that raise your risk of ALL.

This is a review of the diagnosis and treatment of Acute Lymphoblastic Leukemia for medical students in their clinical years and others learning medicine.

Expert clinicians provide final thoughts on the evolving landscape of therapeutic options for acute lymphocytic leukemia (ALL).

The panelists, Raoul Tibes, MD, PhD; Stefan Faderl, MD; and Bijal D. Shah, MD, outline methods of measuring minimal residual disease and its role in the management of acute lymphoblastic leukemia.

Dr. Ryan Cassaday describes the treatment options for acute lymphoblastic leukemia (ALL). There are three different approaches to treating ALL. The induction phase rids the body of the leukemia with chemotherapies. Next is consolidation and intensification to add to induction-phase treatments uses a different combination of drugs from the induction phase to get rid of any residual cancer cells. For many patients, chemotherapy alone is not curative, so they are referred for stem cell / bone marrow transplantation. Additionally, patients can be on maintenance chemotherapy where they are much less potent drugs for a couple years after the initial phase of treatment. Radiation can also sometimes be used if a patient develops a tumor or is present on the skin or brain. Targeted drug therapy is looking promising for treatment. Dr. Cassaday is a hematology oncologist at Seattle Cancer Care Alliance and assistant professor at UW School of Medicine and specializes in treating ALL and lymphomas.

Dr Ching-Hon Pui speaks to ecancer at the 2020 ALL Assembly meeting in Frankfurt about the definition of high-risk acute lymphoblastic leukaemia (ALL).

He explains that high-risk patients cannot be defined based on their immunophenotype, genotype or measuring their early treatment response using minimal residual disease (MRD).

Dr Pui explains that in order to identify these patients, multiple factors such as presenting clinical features, age and germline features.

He discusses the latest research in this area which explore the heterogeneity of the disease and cooperative mutations.

Dr Pui believes that in the next five years, clinicians will be using most of these factors to determine the risk of the patient and therefore the appropriate treatment strategy.

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