Scholarlink

<p>Acute lymphoblastic leukemia (ALL) is the most common childhood cancer and one of the major success stories of modern medicine. Cure rates now approach 90–95%, largely because of multinational risk-adapted intensive protocols, optimized central nervous system prophylaxis, improved supportive care, and genetics- and minimal residual disease (MRD)-guided treatment stratification. Nevertheless, relapse remains the leading cause of death, and the current acute and long-term burden of intensive polychemotherapy is substantial. Blinatumomab, a&#xa0;CD19/CD3 bispecific T‑cell engager, has significantly altered the therapeutic landscape of pediatric B‑cell precursor ALL (B-ALL). In relapsed or refractory B‑ALL and in selected frontline settings, randomized studies have shown that blinatumomab can improve clinically meaningful outcome measures and reduce acute-term toxicity when incorporated into chemotherapy backbones. Other applications, including its add-on in infant <i>KMT2A</i>-rearranged B‑ALL and chemotherapy-substitution strategies in newly diagnosed high-risk disease, are highly promising but require careful interpretation due to as-yet small numbers, trial designs, and a&#xa0;lack of mature outcome data. This review integrates the classic principles of pediatric ALL presentation, diagnosis, and treatment with the currently accumulating evidence on blinatumomab, emphasizing both its practice-changing potential and the unresolved questions of MRD surrogacy, resistance, long-term toxicity, cost, and global implementation.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Pediatric acute lymphoblastic leukemia in the era of blinatumomab: from risk-adapted chemotherapy only to immunotherapy, including concepts of care

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年6月16日

查看全文
  • Andishe Attarbaschi

摘要

Acute lymphoblastic leukemia (ALL) is the most common childhood cancer and one of the major success stories of modern medicine. Cure rates now approach 90–95%, largely because of multinational risk-adapted intensive protocols, optimized central nervous system prophylaxis, improved supportive care, and genetics- and minimal residual disease (MRD)-guided treatment stratification. Nevertheless, relapse remains the leading cause of death, and the current acute and long-term burden of intensive polychemotherapy is substantial. Blinatumomab, a CD19/CD3 bispecific T‑cell engager, has significantly altered the therapeutic landscape of pediatric B‑cell precursor ALL (B-ALL). In relapsed or refractory B‑ALL and in selected frontline settings, randomized studies have shown that blinatumomab can improve clinically meaningful outcome measures and reduce acute-term toxicity when incorporated into chemotherapy backbones. Other applications, including its add-on in infant KMT2A-rearranged B‑ALL and chemotherapy-substitution strategies in newly diagnosed high-risk disease, are highly promising but require careful interpretation due to as-yet small numbers, trial designs, and a lack of mature outcome data. This review integrates the classic principles of pediatric ALL presentation, diagnosis, and treatment with the currently accumulating evidence on blinatumomab, emphasizing both its practice-changing potential and the unresolved questions of MRD surrogacy, resistance, long-term toxicity, cost, and global implementation.