16. Induction Therapy in Adult Acute Lymphoblastic Leukemia

  1. Stefan Faderl MD Associate Professor and
  2. Hagop Kantarjian MD Chairman Professor
  1. Xavier Thomas

Published Online: 4 JAN 2011

DOI: 10.1002/9781444327359.ch16

Leukemias: Principles and Practice of Therapy

Leukemias: Principles and Practice of Therapy

How to Cite

Thomas, X. (2010) Induction Therapy in Adult Acute Lymphoblastic Leukemia, in Leukemias: Principles and Practice of Therapy (eds S. Faderl and H. Kantarjian), Wiley-Blackwell, Oxford, UK. doi: 10.1002/9781444327359.ch16

Editor Information

  1. Department of Leukemia, University of Texas, MD Anderson Cancer Center, Houston, TX, USA

Author Information

  1. Leukemia Unit, Department of Hematology, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France

Publication History

  1. Published Online: 4 JAN 2011
  2. Published Print: 26 NOV 2010

ISBN Information

Print ISBN: 9781405182355

Online ISBN: 9781444327359

SEARCH

Keywords:

  • acute lymphoblastic leukemia;
  • induction chemotherapy;
  • supportive care;
  • targeted therapy;
  • prognosis

Summary

Modern combination chemotherapy programs, adapted from combinations employed by pediatric groups, are now associated with high complete-response rates in adult acute lymphoblastic leukemia (ALL). Standard induction includes a glucocorticoid (vincristine), an anthracycline, and L-asparaginase. Advances have changed the risk assignment of some subsets of ALL. With intensified induction, the balance between efficacy and toxicity must, however, be considered. Supportive care is also of increasing importance during induction, including the concomitant application of hematopoietic colony-stimulating factors throughout chemotherapy. Although most patients can achieve a remission with conventional chemotherapy, outcome of adult ALL remains poor. There is, therefore, a substantial need for new antileukemic drugs. Recent advances in the understanding of the molecular alterations in ALL have led to striking new developments with the arrival of molecular targeted therapies. In the future, an increase of molecular remission rates may be the most important goal and measure for efficacy of induction therapy.