Guidelines Insights: Acute Lymphoblastic Leukemia, Version 1.2019.
Patrick A Brown, Matthew Wieduwilt, Aaron Logan, Daniel J DeAngelo, Eunice S Wang, Amir Fathi, Ryan D Cassaday, Mark Litzow, Anjali Advani, Patricia Aoun, Bhavana Bhatnagar, Michael W Boyer, Teresa Bryan, Patrick W Burke, Peter F Coccia, Steven E Coutre, Nitin Jain, Suzanne Kirby, Arthur Liu, Stephanie Massaro, Ryan J Mattison, Olalekan Oluwole, Nikolaos Papadantonakis, Jae Park, Jeffrey E Rubnitz, Geoffrey L Uy, Kristina M Gregory, Ndiya Ogba, Bijal Shah
Survival outcomes for older adults with acute lymphoblastic leukemia (ALL) are poor and optimal management is challenging due to higher-risk leukemia genetics, comorbidities, and lower tolerance to intensive therapy. A critical understanding of these factors guides the selection of frontline therapies and subsequent treatment strategies. In addition, there have been recent developments in minimal/measurable residual disease (MRD) testing and blinatumomab use in the context of MRD-positive disease after therapy. These NCCN Guidelines Insights discuss recent updates to the NCCN Guidelines for ALL regarding upfront therapy in older adults and MRD monitoring/testing in response to ALL treatment.