Léčba relabující/refrakterní akutní lymfoblastické leukemie dnes a zítra
| Title in English | Therapy of relapsed/refractory acute lymphoblastic leukemia today and tomorrow |
|---|---|
| Authors | |
| Year of publication | 2019 |
| Type | Article in Periodical |
| Magazine / Source | Klinická onkologie |
| Citation | |
| Keywords | Therapy of relapsed/refractory acute lymphoblastic leukemia today and tomorrow |
| Description | Background: New diagnostics and treatments, including the use of new drugs, have advanced considerably the treatment of acute lymphoplastic leukemia (ALL) in the past few years. Monoclonal antibodies and immunoconjugates targeting antigens CD19 and CD22 show greater effi cacy and more favourable toxicity profi les than standard salvage chemotherapeutic protocols. Two of these drugs - blinatumomab and inotuzumab ozogamicin - have already made their way into clinical practice. Ponatinib and other new generation tyrosine kinase inhibitors allow dose reduction of intensive cytostatic regimens in Ph-positive ALL patients and slowly start to overshadow the importance of allogeneic hematopoietic cell transplants. For the time being, their use is reserved for relapsed/ refractory ALL, but they are already available as a fi rst line therapy in clinical trials. An entirely new group of living drugs is emerging for the treatment of ALL - chimeric antigen receptor T-cells produced by genetic modifi cation of native human cells. Chimeric antigen receptor T-cells can be looked upon as in vitro trained professional blast killers. They show an effi cacy never seen before for the treatment of relapsed/refractory ALL. On the other hand, this treatment still presents signifi cant risks, mainly due to cytokine release syndrome. Ruxolitinib, mTOR inhibitors, bortezomib, and other drugs for targeted treatment of ALL are currently being evaluated in clinical trials. Purpose: The article focuses on current options and news in the fi eld of relapsed and refractory ALL treatment. |