Elderly Acute Lymphoblastic Leukemia: Low-Dose Chemotherapy and Immunotherapy Combinations.

Abstract

There is an unmet medical need for the treatment of elderly patients with acute lymphoblastic leukemia (ALL), as only a minority of them achieves long-term survival with current anti-ALL chemotherapy. Here, the recent management of these patients is discussed, including current approaches and future directions, as novel agents developed for refractory/relapsed ALL are now being incorporated into front-line therapies with very promising results. The manuscript will sequentially consider Philadelphia chromosome (Ph) negative ALL, then Ph+ and finally T-ALL. Accordingly, novel strategies using chemo-free approaches and new drugs such as inotuzumab ozogamicin, blinatumomab, venetoclax, tyrosine kinase inhibitors and CAR T-cells will be discussed.