This protocol addresses the management of Acute lymphoblastic leukemia (ALL) specifically in patients aged above 55 years. Standard unmodified pediatric-based protocols are generally not applied in this age group, and treatment strategies must be tailored to this population.
Many groups set an upper age limit for unmodified pediatric-based protocols at the age of 55 years. Patients above this threshold represent a distinct sub-population requiring a dedicated treatment approach.
The approach for B-lineage ALL in this age group incorporates immunotherapy options as part of the management strategy — particularly in specific response situations during or after induction. The full regimen, sequencing, and decision points are detailed in the complete protocol.
DOI: 10.1182/blood.2023023568
Many groups set an upper age limit for unmodified pediatric-based protocols at the age of 55 years.
Immunotherapies such as Blina should be considered in older patients with B-LIN ALL showing persistent MRD; also patients with PR or failure after induction can benefit from treatment with InO or Blina.
Older patients may also benefit from the addition of Ritux to the chemotherapy backbone.
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