Acute lymphoblastic leukemia
ICD-10 C91.0 · ICD-11 2B33.3

Treatment of Acute Lymphoblastic Leukemia in Patients Over 55 Years

Managing acute lymphoblastic leukemia (ALL) in patients older than 55 years requires a tailored approach. Standard unmodified pediatric-based protocols are generally not applied in this age group, and therapy is adapted to account for the specific tolerability profile of older adults.

Patient Population

This protocol applies to adult patients with ALL who are over 55 years of age. Many groups set an upper age limit for unmodified pediatric-based protocols at the age of 55 years, underscoring the need for an age-adapted regimen in this population.

Treatment Approach — Partial Overview

The approach begins with a prephase period aimed at stabilising the patient's general condition before induction starts. Induction therapy is then structured around selected agents chosen for their tolerability in older patients —

The complete regimen, drug sequencing, and consolidation details are available in the full protocol.

Instant Access to Structured Evidence-Based Regimens

References

  1. Many groups set an upper age limit for unmodified pediatric-based protocols at the age of 55 years.
  2. A prephase therapy can be essential particularly for stabilization of the general condition.
  3. As in protocols for younger patients, steroids and vincristine are the most important drugs in induction therapy.
  4. One approach is the use of idarubicin in induction based on a potentially lower cardiac and hepatic toxicity.
  5. Overall, it is advisable to start ASP in older patients later during consolidation.

DOI: 10.1182/blood.2023023568

View source ↗