(ChemotherapyAdvisor) – New from the National Comprehensive Cancer Network (NCCN) are their first ever Clinical Practice Guidelines in Oncology (NCCN Guidelines) for the treatment of Acute Lymphoblastic Leukemia (ALL). The new guidelines were presented by the co-chairs of the NCCN ALL Panel, Joseph C. Alvarnas, MD, Director of Medical Quality and Associate Director in the Division of Hematology and Hemapoietic Cell Transplantation at the City of Hope Comprehensive Cancer Center and Patrick A. Brown, MD, Associate Professor of Oncology and Pediatrics/Director of the Pediatric Leukemia Program, at The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins.
Dr. Brown states that developing a clear standard of treatment for adult acute lymphoblastic leukemia (ALL) is very important. “We now have consistent data demonstrating that young adults – those between the ages of 15 and 39 – with ALL benefit significantly from treatments inspired by those used for children with ALL. The main reason for this is that younger adult patients can tolerate the intensive therapies that we use for our pediatric patients, and this translates into better outcomes. We hope that these new NCCN Guidelines will give oncologists the information they need to ensure that young adult ALL patients receive these intensive therapies,” says Dr. Brown.
Treatment of older ALL patients, which are more difficult to successfully treat than younger patients, is also addressed by the NCCN Guidelines. The difficulty in treating older ALL patients is due, in large part, to the higher frequency of poor-risk cytogenetic abnormalities (e.g., the Philadelphia chromosome) observed among older adults with ALL. Poor prognosis associated with Ph-positive ALL was considered when developing the guidelines and, accordingly, the guidelines for the treatment of ALL are divided (stratified) based on the presence of this abnormality. Other topics covered in the guidelines include the role of allogeneic stem-cell transplantation population, especially in Ph-negative ALL patients.
“ALL is the rarest form of leukemia in adults,” Dr. Brown said. “Its treatment poses many challenges and requires expertise and experience in a number of medical disciplines and supportive-care areas. We recommend that ALL patients be referred to specialized treatment centers, and if possible, enrolled in clinical trials.”