Treatment of Acute Lymphoblastic Leukemia in T-Cell ALL
T-cell acute lymphoblastic leukemia (T-cell ALL) is a distinct subtype of ALL that originates in early precursors of T cells. Recognised under ICD-10 C91.0 and ICD-11 2B33.3, it requires a specific treatment approach guided by this subtype's biology.
T-cell ALL is a type of ALL that starts in early forms of cells that are to become T cells. For adolescents and young adults with T-cell ALL, pediatric, intensive chemotherapy regimens have resulted in improved outcomes.
Management involves an intensive consolidation regimen. For a subset of patients — specifically those with a high level of measurable residual disease at the end of consolidation — an allogeneic stem cell transplant may be recommended.
The complete induction sequence, consolidation protocol, and decision criteria are outlined in the full structured regimen.
- T-cell ALL is a type of ALL that starts in early forms of cells that are to become T cells.
- For adolescents and young adults with T-cell ALL, pediatric, intensive chemotherapy regimens have resulted in improved outcomes.
- Suitable patients should receive early intensified induction with a regimen of four drugs containing vincristine, pegaspargase, an anthracycline (such as daunorubicin or doxorubicin) and a corticosteroid (such as dexamethasone or prednisone), followed by an intensive consolidation regimen.
- Still, an allogeneic stem cell transplant may be recommended for patients who have a high level of measurable residual disease (MRD) at the end of consolidation therapy.