Acute lymphoblastic leukemia (ALL) that has either failed to respond to initial therapy (primary refractory) or has recurred after an initial response (relapsed) represents a distinct and challenging clinical scenario requiring a specific treatment approach.
This protocol addresses patients with relapsed or primary refractory ALL. Depending on protocol and subtype, 5% to 10% of patients will be primary refractory, and an additional 30% to 60% of patients will relapse.
Both groups — those whose disease never achieved remission and those who relapsed — carry a poor prognosis, and the clinical priority is achieving a new complete remission (CR).
Depending on protocol and subtype, 5% to 10% of patients will be primary refractory, and an additional 30% to 60% of patients will relapse.
Adult patients with R/R ALL have a poor prognosis with salvage chemotherapies.
A new CR is attained in 20% to 40% of patients depending on treatment line, but these remissions are in general not durable despite subsequent SCT.
DOI: 10.1182/blood.2023023568
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