Abstract
Acute lymphoblastic leukemia (ALL) is the most frequent neoplastic disease in childhood and accounts for about 20 % of the acute leukemias in adults. An early peak of ALL incidence occurs at the age of 4–5 years and the overall incidence is 1.4 with a male predominance. It is relatively infrequent in younger adults but the incidence seems to increase in adults aged over 50 (Chap. 15). The median age of patients in most adult ALL studies ranges from 25 to 39 years.
Keywords
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Gökbuget N, Wassmann B. New approaches to the treatment of adult acute lymphoblastic leukemia. Mag Eur Med Oncol. 2009;2(2):80–8.
Pui CH, Thiel E. Central nervous system disease in hematologic malignancies: historical perspective and practical applications. Semin Oncol. 2009;36(4 Suppl 2):S2–S16.
Swerdlow SH, Campo E, Harris NL, et al. WHO classification of tumours of haematopoietic and lymphoid tissues. Lyon: International Agency for Research on Cancer; 2008.
Bene MC, Castoldi G, et al. Proposals for the immunological classification of acute leukemias. European Group for the Immunological Characterization of Leukemia (EGICL). Leukemia. 1995;9:1783–6.
Ludwig WD, Raghavachar A, Thiel E. Immunophenotypic classification of acute lymphoblastic leukemia. Baillieres Clin Haematol. 1994;7(2):235.
Szczepanski T. Why and how to quantify minimal residual disease in acute lymphoblastic leukemia? Leukemia. 2007;21(4):622–6.
van der Velden V, Cazzaniga G, Schrauder A, et al. Analysis of minimal residual disease by Ig/TCR gene rearrangements: guidelines for interpretation of real-time quantitative PCR data. Leukemia. 2007;21(4):604–11.
Bruggemann M, Schrauder A, Raff T, et al. Standardized MRD quantification in European ALL trials: proceedings of the Second International Symposium on MRD assessment in Kiel, Germany, 18–20 September 2008. Leukemia. 2010;24(3):521–35.
Coiffier B, Altman A, Pui CH, Younes A, Cairo MS. Guidelines for the management of pediatric and adult tumor lysis syndrome: an evidence-based review. J Clin Oncol. 2008;26(16):2767–78.
Geissler K, Koller E, Hubmann E, et al. Granulocyte colony-stimulating factor as an adjunct to induction chemotherapy for adult acute lymphoblastic leukemia–a randomized phase-III study. Blood. 1997;90(2):590–6.
Kantarjian HM, Estey E, O’Brien S, et al. Granulocyte-stimulating factor supportive treatment following intensive chemotherapy in acute lymphocytic leukemia first remission. Cancer. 1993;72:2950–5.
Larson RA, Dodge RK, Linker CA, et al. A randomized controlled trial of filgrastim during remission induction and consolidation chemotherapy for adults with acute lymphoblastic leukemia: CALGB study 9111. Blood. 1998;92(5):1556–64.
Ottmann OG, Hoelzer D, Gracien E, et al. Concomitant granulocyte colony-stimulating factor and induction chemoradiotherapy in adult acute lymphoblastic leukemia: a randomized phase III trial. Blood. 1995;86(2):444–50.
Pui CH, Howard SC. Current management and challenges of malignant disease in the CNS in paediatric leukaemia. Lancet Oncol. 2008;9(3):257–68.
Mancini M. An integrated molecular-cytogenetic classification is highly predictive of outcome in adult acute lymphoblastic leukemia (ALL): Analysis of 395 cases enrolled in the GIMEMA 0496 trial. Blood. 2001;98(11):3492a.
Wetzler M, Sanford BL, Kurtzberg J, et al. Effective asparagine depletion with pegylated asparaginase results in improved outcomes in adult acute lymphoblastic leukemia: Cancer and Leukemia Group B Study 9511. Blood. 2007;109(10):4164–7.
Annino L, Vegna ML, Camera A, et al. Treatment of adult acute lymphoblastic leukemia (ALL): long-term follow-up of the GIMEMA ALL 0288 randomized study. Blood. 2002;99(3):863–71.
Kantarjian HM, O’Brien S, Smith TL, et al. Results of treatment with hyper-CVAD, a dose-intensive regimen, in adult acute lymphocytic leukemia. J Clin Oncol. 2000;18(3):547–61.
Cheson BD, Bennett JM, Kopecky KJ, et al. Revised recommendations of the International Working Group for Diagnosis, Standardization of response criteria, treatment outcomes, and reporting standards for therapeutic trials in acute myeloid leukemia. J Clin Oncol. 2003;21(24):4642–9.
Kantarjian H, Thomas D, O’Brien S, et al. Long-term follow-up results of hyperfractionated cyclophosphamide, vincristine, doxorubicin, and dexamethasone (Hyper-CVAD), a dose-intensive regimen, in adult acute lymphocytic leukemia. Cancer. 2004;101(12):2788–801.
Pui CH, Robison LL, Look AT. Acute lymphoblastic leukaemia. Lancet. 2008;371(9617):1030–43.
Conter V, Valsecchi MG, Silvestri D, et al. Pulses of vincristine and dexamethasone in addition to intensive chemotherapy for children with intermediate-risk acute lymphoblastic leukaemia: a multicentre randomised trial. Lancet. 2007;369(9556):123–31.
Thiebaut A, Vernant JP, Degos L, et al. Adult acute lymphocytic leukemia study testing chemotherapy and autologous and allogeneic transplantation A follow-up report of the French protocol LALA 87. Hematol Oncol Clin North Am. 2000;14(6):1353–66.
Bassan R, Pogliani E, Casula P, et al. Risk-oriented postremission strategies in adult acute lymphoblastic leukemia: prospective confirmation of anthracycline activity in standard-risk class and role of hematopoietic stem cell transplants in high-risk groups. Hematol J. 2001;2(2):117–26.
Gökbuget N, Arnold R, Buechner T, et al. Intensification of induction and consolidation improves only subgroups of adult ALL: analysis of 1200 patients in GMALL study 05/93. Blood. 2001;98(11):802a.
Takeuchi J, Kyo T, Naito K, et al. Induction therapy by frequent administration of doxorubicin with four other drugs, followed by intensive consolidation and maintenance therapy for adult acute lymphoblastic leukemia: the JALSG-ALL93 study. Leukemia. 2002;16(7):1259–66.
Linker C, Damon L, Ries C, Navarro W. Intensified and shortened cyclical chemotherapy for adult acute lymphoblastic leukemia. J Clin Oncol. 2002;20(10):2464–71.
Hallbook H, Simonsson B, Ahlgren T, et al. High-dose cytarabine in upfront therapy for adult patients with acute lymphoblastic leukaemia. Br J Haematol. 2002;118(3):748–54.
Labar B, Suciu S, Zittoun R, et al. Allogeneic stem cell transplantation in acute lymphoblastic leukemia and non-Hodgkin’s lymphoma for patients ≤50 years old in first complete remission: results of the EORTC ALL-3 trial. Haematologica. 2004;89(7):809–17.
Thomas X, Boiron JM, Huguet F, et al. Outcome of treatment in adults with acute lymphoblastic leukemia: analysis of the LALA-94 trial. J Clin Oncol. 2004;22(20):4075–86.
Hunault M, Harousseau JL, Delain M, et al. Better outcome of adult acute lymphoblastic leukemia after early genoidentical allogeneic bone marrow transplantation (BMT) than after late high-dose therapy and autologous BMT: a GOELAMS trial. Blood. 2004;104(10):3028–37.
Rowe JM, Buck G, Burnett AK, et al. Induction therapy for adults with acute lymphoblastic leukemia: results of more than 1500 patients from the international ALL trial: MRC UKALL XII/ECOG E2993. Blood. 2005;106(12):3760–7.
Mancini M, Scappaticci D, Cimino G, et al. A comprehensive genetic classification of adult acute lymphoblastic leukemia (ALL): analysis of the GIMEMA 0496 protocol. Blood. 2005;105(9):3434–41.
Ribera JM, Oriol A, Bethencourt C, et al. Comparison of intensive chemotherapy, allogeneic or autologous stem cell transplantation as post-remission treatment for adult patients with high-risk acute lymphoblastic leukemia. Results of the PETHEMA ALL-93 trial. Haematologica. 2005;90(10):1346–56.
Tobinai K, Takeyama K, Arima F, et al. Phase II study of chemotherapy and stem cell transplantation for adult acute lymphoblastic leukemia or lymphoblastic lymphoma: Japan Clinical Oncology Group Study 9004. Cancer Sci. 2007;98(9):1350–7.
Gökbuget N, Arnold R, Bîhme A, et al. Improved outcome in high risk and very high risk ALL by risk adapted SCT and in standard risk ALL by intensive chemotherapy in 713 adult ALL patients treated according to the prospective GMALL study 07/2003. Blood 2007;110(11):abstract #12.
Bassan R, Spinelli O, Oldani E, et al. Improved risk classification for risk-specific therapy based on the molecular study of MRD in adult ALL. Blood. 2009;113(18):4153–62.
Omura GA, Moffitt S, Vogler WR, Salter MM. Combination chemotherapy of adult acute lymphoblastic leukemia with randomized central nervous prophylaxis. Blood. 1980;55:199–9.
Cortes J, O’Brien SM, Pierce S, Keating MJ, Freireich EJ, Kantarjian HM. The value of high-dose systemic chemotherapy and intrathecal therapy for central nervous system prophylaxis in different risk groups of adult acute lymphoblastic leukemia. Blood. 1995;86:2091–7.
Law IP, Blom J. Adult acute leukemia: frequency of central system involvement in long term survivors. Cancer. 1977;40(3):1304–6.
Clarkson B, Ellis S, Little C, et al. Acute lymphoblastic leukemia in adults. Semin Oncol. 1984;12:160.
Hussein KK, Dahlberg S, Head D, et al. Treatment of acute lymphoblastic leukemia in adults with intensive induction, consolidation and maintenance chemotherapy. Blood. 1989;73(1):57–63.
Lluesma-Gonalons M, Pavlovsky S, Santarelli MT, et al. Improved results of an intensified therapy in adult acute lymphocytic leukemia. Ann Oncol. 1991;2:33–9.
Ellison RR, Mick R, Cuttner J, et al. The effects of postinduction intensification treatment with cytarabine and daunorubicin in adult acute lymphocytic leukemia: a prospective randomized clinical trial by cancer and leukemia group B. J Clin Oncol. 1991;9:2002–15.
Henderson ES, Scharlau C, Cooper MR, et al. Combination chemotherapy and radiotherapy for acute lymphocytic leukemia in adults: results of CALGB protocol 7113. Leuk Res. 1979;3(6):395–407.
Larson RA, Dodge RK, Burns CP, et al. A five-drug remission induction regimen with intensive consolidation for adults with acute lymphoblastic leukemia: Cancer and Leukemia Group B study 8811. Blood. 1995;85:2025–37.
Gökbuget N, Aguion-Freire E, Diedrich H, et al. Characteristics and outcome of CNS relapse in patients with acute lymphoblastic leukemia (ALL). Blood. 1999;94(10,S1):1287a.
Wiernik PH, Dutcher JP, Paietta E, et al. Long-term follow-up of treatment and potential cure of adult acute lymphocytic leukemia with MOAD: a non-anthracycline containing regimen. Leukemia. 1993;7:1236–41.
Bassan R, Pogliani E, Lerede T, et al. Fractionated cyclophosphamide added to the IVAP regimen (idarubicin- vincristine-l-asparaginase-prednisone) could lower the risk of primary refractory disease in T-lineage but not B-lineage acute lymphoblastic leukemia: first results from a phase II clinical study. Haematologica. 1999;84(12):1088–93.
Durrant IJ, Prentice HG, Richards SM. Intensification of treatment for adults with acute lymphoblastic leukaemia: results of U.K. Medical Research council randomized trial UKALL XA. Br J Haematol. 1997;99:84–92.
Ribera JM, Ortega JJ, Oriol A, et al. Late intensification chemotherapy has not improved the results of intensive chemotherapy in adult acute lymphoblastic leukemia. Results of a prospective multicenter randomized trial (PETHEMA ALL-89). Spanish Society of Hematology. Haematologica. 1998;83(3):222–30.
Todeschini G, Tecchio C, Meneghini V, et al. Estimated 6-year event-free survival of 55 % in 60 consecutive adult acute lymphoblastic leukemia patients treated with an intensive phase II protocol based on high induction dose of daunorubicin. Leukemia. 1998;12:144–9.
Kantarjian HM, Walters RS, Smith TL, et al. Identification of risk groups for development of central nervous system leukemia in adults with acute lymphocytic leukemia. Blood. 1988;72(5):1784–9.
Howell SB. Liposomal cytarabine for the treatment of lymphomatous meningitis. Biol Ther Lymphoma. 2003;6:10–4.
Jabbour E, O’Brien S, Kantarjian H, et al. Neurologic complications associated with intrathecal liposomal cytarabine given prophylactically in combination with high-dose methotrexate and cytarabine to patients with acute lymphocytic leukemia. Blood. 2007;109(8):3214–8.
Bachanova V, Weisdorf D. Unrelated donor allogeneic transplantation for adult acute lymphoblastic leukemia: a review. Bone Marrow Transplant. 2008;41(5):455–64.
Gökbuget N, Hoelzer D. Treatment of adult acute lymphoblastic leukemia. Semin Hematol. 2009;46(1):64–75.
Chaidos A, Kanfer E, Apperley JF. Risk assessment in haemotopoietic stem cell transplantation: disease and disease stage. Best Pract Res Clin Haematol. 2007;20(2):125–54.
Loberiza F. Summary slides 2003 – part III. IMBTR/ABMTR Newslett. 2006;10(2):6–9.
Goldstone AH, Lazarus HJ, Richards SM, et al. The outcome of 551 1st CR transplants in adult ALL from the UKALL XII/ECOG 2993 Study. Blood. 2004;104(11):615.
Arnold R, Beelen D, Bunjes D, et al. Phenotype predicts outcome after allogeneic stem cell transplantation in adult high risk ALL patients. Blood 2003;102(11):abstract #1719.
Giebel S, Stella-Holowiecka B, Krawczyk-Kulis M, et al. Status of minimal residual disease determines outcome of autologous hematopoietic SCT in adult ALL. Bone Marrow Transplant. 2010;45:1095–101.
Tse W, Laughlin MJ. Umbilical cord blood transplantation: a new alternative option. Hematology Am Soc Hematol Educ Program 2005:377–383.
Eapen M, Rubinstein P, Zhang MJ, et al. Outcomes of transplantation of unrelated donor umbilical cord blood and bone marrow in children with acute leukaemia: a comparison study. Lancet. 2007;369(9577):1947–54.
Rocha V, Labopin M, Sanz G, et al. Transplants of umbilical-cord blood or bone marrow from unrelated donors in adults with acute leukemia. N Engl J Med. 2004;351(22):2276–85.
Klingebiel T, Handgretinger R, Lang P, Bader P, Niethammer D. Haploidentical transplantation for acute lymphoblastic leukemia in childhood. Blood Rev. 2004;18(3):181–92.
Ciceri F, Labopin M, Aversa F, et al. A survey of fully haploidentical hematopoietic stem cell transplantation in adults with high-risk acute leukemia: a risk factor analysis of outcomes for patients in remission at transplantation. Blood. 2008;112(9):3574–81.
Singhal S, Henslee-Downey PJ, Powles R, et al. Haploidentical vs autologous hematopoietic stem cell transplantation in patients with acute leukemia beyond first remission. Bone Marrow Transplant. 2003;31(10):889–95.
Mohty M, Labopin M, Tabrizzi R, et al. Reduced intensity conditioning allogeneic stem cell transplantation for adult patients with acute lymphoblastic leukemia: a retrospective study from the European Group for Blood and Marrow Transplantation. Haematologica. 2008;93(2):303–6.
Arnold R, Massenkeil G, Bornhauser M, et al. Nonmyeloablative stem cell transplantation in adults with high-risk ALL may be effective in early but not in advanced disease. Leukemia. 2002;16(12):2423–8.
Marks DI, Wang T, Perez WS, et al. The outcome of full-intensity and reduced-intensity conditioning matched sibling or unrelated donor transplantation in adults with Philadelphia chromosome-negative acute lymphoblastic leukemia in first and second complete remission. Blood. 2010;116(3):366–74.
Mohty M, Labopin M, Volin L, et al. Reduced-intensity versus conventional myeloablative conditioning allogeneic stem cell transplantation for patients with acute lymphoblastic leukemia: a retrospective study from the European Group for Blood and Marrow Transplantation. Blood. 2010;116:4439–43.
Fiere D. Adult acute lymphoblastic leukemia: a multicentric randomized trial testing bone marrow transplantation as postremission therapy. The French Group on Therapy for Adult Acute Lymphoblastic Leukemia. J Clin Oncol. 1993;11:1990–2001.
Sebban C, Lepage E, Vernant JP, et al. Allogeneic bone marrow transplantation in adult acute lymphoblastic leukemia in first complete remission: a comparative study. J Clin Oncol. 1994;12:2580–7.
Gupta V, Yi QL, Brandwein J, et al. The role of allogeneic bone marrow transplantation in adult patients below the age of 55 years with acute lymphoblastic leukemia in first complete remission: a donor vs no donor comparison. Bone Marrow Transplant. 2004;33(4):397–404.
Attal M, Blaise D, Marit G, et al. Consolidation treatment of adult acute lymphoblastic leukemia: a prospective, randomized trial comparing allogeneic versus autologous bone marrow transplantation and testing the impact of recombinant interleukin-2 after autologous bone marrow transplantation. Blood. 1995;86:1619–28.
Rowe J, Buck G, Fielding A, et al. In adults with standard-risk acute lymphoblastic leukemia (ALL) the greatest benefit is achieved from an allogeneic transplant in first complete remission (CR) and an autologous transplant is less effective than conventional consolidation/maintenance chemotherapy: final results of the international ALL trial (MRC UKALL XII/ECOG E2993). Blood 2006;108(11):#2.
Cornelissen JJ, Carston M, Kollman C, et al. Unrelated marrow transplantation for adult patients with poor-risk acute lymphoblastic leukemia: strong graft-versus-leukemia effect and risk factors determining outcome. Blood. 2001;97(6):1572–7.
Hahn T, Wall D, Camitta B, et al. The role of cytotoxic therapy with hematopoietic stem cell transplantation in the therapy of acute lymphoblastic leukemia in adults: an evidence-based review. Biol Blood Marrow Transplant. 2006;12(1):1–30.
Yanada M, Matsuo K, Suzuki T, Naoe T. Allogeneic hematopoietic stem cell transplantation as part of postremission therapy improves survival for adult patients with high-risk acute lymphoblastic leukemia: a metaanalysis. Cancer. 2006;106(12):1657–63.
Gökbuget N, Hoelzer D. Risk-adapted treatment of acute lymphoblastic leukemia. Hematology Education (The Education Programme for the Annual Congress of the European Haematology Association) 2008:64–70.
Rowe JM. Prognostic factors in adult acute lymphoblastic leukaemia. Br J Haematol. 2010;150(4):389–405.
Goldstone AH, Richards SM, Lazarus HM, et al. In adults with standard-risk acute lymphoblastic leukemia (ALL) the greatest benefit is achieved from a matched sibling allogeneic transplant in first complete remission (CR) and an autologous transplant is less effective than conventional consolidation/maintenance chemotherapy in All patients: final results of the international ALL trial (MRC UKALL XII/ECOG E2993). Blood. 2008;111(4):1827–33.
Taylor PR, Reid MM, Proctor SJ. Acute lymphoblastic leukaemia in the elderly. Leuk Lymphoma. 1994;13(5–6):373–80.
Pagano L, Mele L, Casorelli I, Fianchi L, Di FA, Leone G. Acute lymphoblastic leukemia in the elderly. A twelve-year retrospective, single center study. Haematologica. 2000;85(12):1327–9.
Ferrari A, Annino L, Crescenzi S, Romani C, Mandelli F. Acute lymphoblastic leukemia in the elderly: results of two different treatment approaches in 49 patients during a 25-year period. Leukemia. 1995;9:1643–7.
Legrand O, Marie JP, Marjanovic Z, et al. Prognostic factors in elderly acute lymphoblastic leukaemia. Br J Haematol. 1997;97:596–602.
Delannoy A, Ferrant A, Bosly A, et al. Acute lymphoblastic leukemia in the elderly. Eur J Haematol. 1990;45(2):90–3.
Spath-Schwalbe E, Heil G, Heimpel H. Acute lymphoblastic leukemia in patients over 59 years of age Experience in a single center over a 10-year period. Ann Hematol. 1994;69(6):291–6.
Thomas X, Olteanu N, Charrin C, Lheritier V, Magaud JP, Fiere D. Acute lymphoblastic leukemia in the elderly: The Edouard Herriot Hospital experience. Am J Hematol. 2001;67(2):73–83.
Offidani M, Corvatta L, Malerba L, et al. Comparison of two regimens for the treatment of elderly patients with acute lymphoblastic leukaemia (ALL). Blood. 2004;104(11):4490.
Nagura E, Minami S, Nagata K, et al. Analysis of elderly patients, aged 60 years old or over, with acute lymphoblastic leukemia. Nippon Ronen Igakkai Zasshi. 1999;36(1):52–8.
Onciu M, Lai R, Kantarjian H, Ball G, Smith T, Buesco-Ramos C. Acute lymphoblastic leukemia (ALL) in the elderly – the significance of the philadelphia chromosome. Blood. 2000;96(11):4558.
Robak T. Acute lymphoblastic leukaemia in elderly patients: biological characteristics and therapeutic approaches. Drugs Aging. 2004;21(12):779–91.
Kantarjian HM, O’Brien S, Smith T, et al. Acute lymphocytic leukaemia in the elderly: characteristics and outcome with the vincristine-adriamycin-dexamethasone (VAD) regimen. Br J Haematol. 1994;88:94–100.
Mandelli F, Annino L, Ferrari A, for the GG. ALL in elderly: The GIMEMA trials. Ann Hematol 1995;70(S2):41a.
Todeschini G, Tecchio C, Meneghini V, et al. Acute lymphoblastic leukemia (ALL) in elderly patients receiving intensive treatment. Experience in 26 consecutive patients. Blood. 1996;88 Suppl 1:170a.
Bassan R, Di BE, Lerede T, et al. Age-adapted moderate-dose induction and flexible outpatient postremission therapy for elderly patients with acute lymphoblastic leukemia. Leuk Lymphoma. 1996;22(3–4):295–301.
Delannoy A, Sebban C, Cony-Makhoul P, et al. Age-adapted induction treatment of acute lymphoblastic leukemia in the elderly and assessment of maintenance with interferon combined with chemotherapy. A multicentric prospective study in forty patients. Leukemia. 1997;11:1429–34.
Delannoy A, Cazin B, Thomas X, et al. Treatment of acute lymphoblastic leukemia in the elderly: an evaluation of interferon alpha given as a single agent after complete remission. Leuk Lymphoma. 2002;43(1):75–81.
Gökbuget N, de Wit M, Gerhardt A, et al. Results of a shortened, dose reduced treatment protocol in elderly patients with acute lymphoblastic leukemia (ALL). Blood. 2000;96(11):3104a.
Goekbuget N, Leguay T, Hunault M, et al. First European chemotherapy schedule for elderly patients with acute lymphoblastic leukemia: promising remission rate and feasible moderate dose intensity consolidation. Blood 2008;112.
Bassan R, Di Bona E, Lerede T, et al. Age-adapted moderate-dose induction and flexible outpatients postremission therapy for elderly patients with acute lymphoblastic leukemia. Leuk Lymphoma. 1996;22:295–301.
Stock W, La M, Sanford B, et al. What determines the outcomes for adolescents and young adults with acute lymphoblastic leukemia treated on cooperative group protocols? A comparison of children’s cancer group and cancer and leukemia group b studies. Blood. 2008;112(5):1646–54.
Ribera JM, Oriol A, Sanz MA, et al. Comparison of the results of the treatment of adolescents and young adults with standard-risk acute lymphoblastic leukemia with the Programa Espanol de Tratamiento en Hematologia pediatric-based protocol ALL-96. J Clin Oncol. 2008;26(11):1843–9.
Gökbuget N, Arnold R, Bîhme A, et al. Risk adapted treatment of adolescents with acute lymphoblastic leukemia (ALL) according to the German Multicenter Study Group (GMALL) Studies 09/99 and 07/03 Yields Significantly Different Outcome for Subgroups. Hematologica. 2007;92 Suppl 1:135.
Huguet F, Raffoux E, Thomas X, et al. Towards a pediatric approach in adults with acute lymphoblastic leukemia (ALL): The GRAALL-2003 Study. Blood. 2006;108(11):147.
Hoelzer D, Thiel E, Lîffler H, et al. Prognostic factors in a multicenter study for treatment of acute lymphoblastic leukemia in adults. Blood. 1988;71:123–31.
Gökbuget N, Hoelzer D, Arnold R, et al. Subtypes and treatment outcome in adult acute lymphoblastic leukemia (ALL) less than or greater than 55 yrs. Hematol J. 2001;1 Suppl 1:694a.
Ludwig WD, Rieder H, Bartram CR, et al. Immunophenotypic and genotypic heterogeneity of adult pre-pre-B acute lymphoblastic leukemia (ALL): Experience of the German Multicentre Trials (GMALL 03/87 and 04/89). Blood. 1994;84(S1):516a.
Gleissner B, Gökbuget N, Rieder H, et al. CD10-negative pre-B acute lymphoblastic leukemia (ALL): a distinct high-risk subgroup of adult ALL associated with a high frequency of MLL aberrations. Results of the German Multicenter Trials for Adult ALL (GMALL). Blood. 2005;106(13):4054–6.
Maury S, Huguet F, Leguay T, et al. Adverse prognostic significance of CD20 expression in adults with Philadelphia chromosome-negative B-cell precursor acute lymphoblastic leukemia. Haematologica. 2010;95(2):324–8.
Thomas DA, O’Brien S, Faderl S, et al. Chemoimmunotherapy with a modified hyper-CVAD and rituximab regimen improves outcome in de novo Philadelphia chromosome-negative precursor B-lineage acute lymphoblastic leukemia. J Clin Oncol. 2010;28(24):3880–9.
Hoelzer D, Thiel E, Arnold R et al. Successful subtype oriented treatment strategies in adult T-all; results of 744 patients treated in three consecutive GMALL studies. ASH Annual Meeting Abstracts November 20, 2009;114(22):324.
Grabher C, von Boehmer H, Look AT. Notch 1 activation in the molecular pathogenesis of T-cell acute lymphoblastic leukaemia. Nat Rev Cancer. 2006;6(5):347–59.
Vitale A, Guarini A, Ariola C, et al. Adult T-cell acute lymphoblastic leukemia: biologic profile at presentation and correlation with response to induction treatment in patients enrolled in the GIMEMA LAL 0496 protocol. Blood. 2006;107(2):473–9.
Asnafi V, Buzyn A, Thomas X, et al. Impact of TCR status and genotype on outcome in adult T-cell acute lymphoblastic leukemia: a LALA-94 study. Blood. 2005;105(8):3072–8.
Baldus CD, Martus P, Burmeister T, et al. Low ERG and BAALC expression identifies a new subgroup of adult acute T-lymphoblastic leukemia with a highly favorable outcome. J Clin Oncol. 2007;25(24):3739–45.
Hoelzer D, Ludwig WD, Thiel E, et al. Improved outcome in adult B-cell acute lymphoblastic leukemia. Blood. 1996;87:495–508.
Hoelzer D, Hiddemann W, Baumann A, et al. High survival rate in adult burkitts lymphoma/leukemia and diffuse large B-cell lymphoma with mediastinal involvement. Blood 2007;110(11):abstract #518.
Thomas DA, Faderl S, O’Brien S, et al. Chemoimmunotherapy with hyper-CVAD plus rituximab for the treatment of adult Burkitt and Burkitt-type lymphoma or acute lymphoblastic leukemia. Cancer. 2006;106(7):1569–80.
Moorman AV, Harrison CJ, Buck GA, et al. Karyotype is an independent prognostic factor in adult acute lymphoblastic leukemia (ALL): analysis of cytogenetic data from patients treated on the Medical Research Council (MRC) UKALLXII/Eastern Cooperative Oncology Group (ECOG) 2993 trial. Blood. 2007;109(8):3189–97.
Ottmann OG, Druker BJ, Sawyers CL, et al. A phase II study of Imatinib Mesylate (Glivec) in Patients with relapsed or refractory Philadelphia chromosome-positive acute lymphoid leukemias. Blood. 2002;100(6):1965–71.
Wassmann B, Pfeifer H, Scheuring U, et al. Therapy with imatinib mesylate (Glivec) preceding allogeneic stem cell transplantation (SCT) in relapsed or refractory Philadelphia-positive acute lymphoblastic leukemia (Ph + ALL). Leukemia. 2002;16(12):2358–65.
Ottmann OG, Pfeifer H (2009) Management of Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph + ALL). Hematology Am Soc Hematol Educ Program 2009:371–381
Lee S, Kim YJ, Min CK, et al. The effect of first-line imatinib interim therapy on the outcome of allogeneic stem cell transplantation in adults with newly diagnosed Philadelphia chromosome-positive acute lymphoblastic leukemia. Blood. 2005;105(9):3449–57.
Wassmann B, Pfeifer H, Gîkbuget N, et al. Alternating versus concurrent schedules of Imatinib and chemotherapy as front-line therapy for Philadelphia-positive acute lymphoblastic leukemia (Ph + ALL). Blood. 2006;108(5):1469–77.
Yanada M, Takeuchi J, Sugiura I, et al. High complete remission rate and promising outcome by combination of imatinib and chemotherapy for newly diagnosed BCR–ABL-positive acute lymphoblastic leukemia: a phase II study by the Japan Adult Leukemia Study Group. J Clin Oncol. 2006;24(3):460–6.
de Labarthe A, Rousselot P, Huguet-Rigal F, et al. Imatinib combined with induction or consolidation chemotherapy in patients with de novo Philadelphia chromosome-positive acute lymphoblastic leukemia: results of the GRAAPH-2003 study. Blood. 2007;109(4):1408–13.
Thomas DA, Kantarjian H, Cortes J, et al. Outcome with the hyper-CVAD and imatinib mesylate regimen as frontline therapy for adult Philadelphia (Ph) positive acute lymphocytic leukemia (ALL). Blood 2006;108(11):#284.
Bassan R, Rossi G, Pogliani EM, et al. Chemotherapy-phased imatinib pulses improve long-term outcome of adult patients with Philadelphia chromosome-positive acute lymphoblastic leukemia: Northern Italy Leukemia Group protocol 09/00. J Clin Oncol. 2010;28(22):3644–52.
Ribera JM, Oriol A, Gonzalez M, et al. Concurrent intensive chemotherapy and imatinib before and after stem cell transplantation in newly diagnosed Philadelphia chromosome-positive acute lymphoblastic leukemia. Final results of the CSTIBES02 trial. Haematologica. 2010;95(1):87–95.
Wassmann B, Pfeifer H, Brück P, et al. Imatinib for molecular relapse of Philadelphia chromosome positive acute lymphoblastic leukemia (Ph + ALL) after stem cell transplantation - early molecular response determines outcome. Onkologie. 2004;27 Suppl 3:76 (#370).
Ottmann OG, Wassmann B, Pfeifer H, et al. Imatinib compared with chemotherapy as front-line treatment of elderly patients with Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph + ALL). Cancer. 2007;109(10):2068–76.
Vignetti M, Fazi P, Cimino G, et al. Imatinib plus steroids induces complete remissions and prolonged survival in elderly Philadelphia chromosome-positive acute lymphoblastic leukemia patients without additional chemotherapy: results of the GIMEMA LAL0201-B protocol. Blood. 2007;109(9):3676–8.
Pfeifer H, Wassmann B, Pavlova A, et al. Kinase domain mutations of BCR–ABL frequently precede imatinib-based therapy and give rise to relapse in patients with de novo Philadelphia-positive acute lymphoblastic leukemia (Ph + ALL). Blood. 2007;110(2):727–34.
Kantarjian H, Giles F, Wunderle L, et al. Nilotinib in imatinib-resistant CML and Philadelphia chromosome-positive ALL. N Engl J Med. 2006;354(24):2542–51.
Talpaz M, Shah NP, Kantarjian H, et al. Dasatinib in imatinib-resistant Philadelphia chromosome-positive leukemias. N Engl J Med. 2006;354(24):2531–41.
Ravandi F, O’Brien S, Thomas D, et al. First report of phase II study of dasatinib with hyperCVAD for the frontline treatment of patients with Philadelphia chromosome positive (Ph+) acute lymphoblastic leukemia. Blood May 13 2010.
Conter V, Bartram CR, Valsecchi MG, et al. Molecular response to treatment redefines all prognostic factors in children and adolescents with B-cell precursor acute lymphoblastic leukemia: results in 3184 patients of the AIEOP-BFM ALL 2000 study. Blood. 2010;115(16):3206–14.
Gökbuget N, Brueggemann M, Arnold R et al. New definition of treatment response in adult acute lymphoblastic leukemia (ALL): Use of molecular markers for minimal residual disease (MRD). ASH Annual Meeting Abstracts November 20 2009;114(22):90.
Bruggemann M, Raff T, Flohr T, et al. Clinical significance of minimal residual disease quantification in adult patients with standard-risk acute lymphoblastic leukemia. Blood. 2006;107(3):1116–23.
Raff T, Gökbuget N, Luschen S, et al. Molecular relapse in adult standard-risk ALL patients detected by prospective MRD monitoring during and after maintenance treatment: data from the GMALL 06/99 and 07/03 trials. Blood. 2007;109(3):910–5.
Hagedorn N, Acquaviva C, Fronkova E, et al. Submicroscopic bone marrow involvement in isolated extramedullary relapses in childhood acute lymphoblastic leukemia: a more precise definition of “isolated” and its possible clinical implications, a collaborative study of the Resistant Disease Committee of the International BFM study group. Blood. 2007;110(12):4022–9.
Spinelli O, Peruta B, Tosi M, et al. Clearance of minimal residual disease after allogeneic stem cell transplantation and the prediction of the clinical outcome of adult patients with high-risk acute lymphoblastic leukemia. Haematologica. 2007;92(5):612–8.
Wassmann B, Pfeifer H, Stadler M, et al. Early molecular response to posttransplantation imatinib determines outcome in MRD + Philadelphia-positive acute lymphoblastic leukemia (Ph + ALL). Blood. 2005;106(2):458–63.
Armstrong SA, Look AT. Molecular genetics of acute lymphoblastic leukemia. J Clin Oncol. 2005;23(26):6306–15.
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Goekbuget, N., Hoelzer, D. (2013). Diagnosis and Treatment of Adult Acute Lymphoblastic Leukemia. In: Wiernik, P., Goldman, J., Dutcher, J., Kyle, R. (eds) Neoplastic Diseases of the Blood. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-3764-2_20
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