Acute lymphoblastic leukemia (ALL)
About
ALL is a malignant blood disease in which lymphocytes proliferate abnormally in the bone marrow. The cure rate of childhood ALL can reach 85-90%, but the prognosis of relapsed/refractory ALL is extremely poor. The prognosis of adult ALL is poor, with a 5-year survival rate of approximately 40%. Core dilemmas: ① Relapsed/refractory ALL is resistant to traditional chemotherapy;② Hematopoietic stem cell transplantation is a radical treatment but has difficulty in matching and transplant-related complications;③ Although CAR-T cell therapy has made breakthroughs in B-ALL, long-term remission rates and toxicity management remain challenges.
Features & Symptoms
- Malignant proliferation of lymphocytes in bone marrow
- Normal hematopoiesis is suppressed
- Anemia, bleeding, infection
- Most common malignant tumors in children
Treatment Options
| Treatment | Description | Stage | Price Range |
|---|---|---|---|
| CD19/CD22 CAR-T cell therapy | Tisagenlecleucel (Kymriah) and Bresucabtagene autoleucel (Tecartus) have been FDA approved for use in relapsed/refractory B-ALL. Complete remission rates can reach 80-90%. | FDA批准 | $400K - $1M/疗程 |
| Blinatumomab | CD19/CD3 dual-specific T cell adapter, used for bridging treatment of relapsed/refractory B-ALL or clearance of minimal residual disease. | FDA批准 | $150K - $400K/疗程 |
| allogeneic hematopoietic stem cell transplantation | All-matched siblings or unrelated donor transplantation after myeloablative pretreatment is the only possible method to cure ALL. | 临床应用 | $300K - $800K/次 |
Prognosis
Median survival for relapsed/refractory ALL is less than 6 months
Additional Notes
Notes: Post-CAR-T management: After CAR-T treatment, cytokine release syndrome (CRS) and immune effector cell-related neurotoxic syndromes (ICANS) need to be closely monitored and must be performed in centers with ICU conditions;CRS grading management: Grade 1 CRS can be treated symptomatic, Grade 2 requires tocilizumab, Grade ≥3 requires ICU support; Central nervous system prevention: Whether central nervous system preventive treatment (such as intrathecal injection) needs to be evaluated; Transplantation evaluation: Indications for allogeneic hematopoietic stem cell transplantation should be evaluated as soon as possible after complete remission is achieved; Minimal residual disease (MRD) monitoring: MRD should be monitored regularly after treatment. Patients with MRD negative have a significantly better prognosis. Exclusive service commitment: The platform will allocate a dedicated medical team to each patient to assist in dismantling and properly deploying the following precautions throughout the process. When cross-state and cross-border diagnosis and treatment projects or drugs are involved, the platform will make overall arrangements for the entire docking; for disabled and semi-disabled patient groups, the platform will provide rush-free alternative solutions (including remote consultation, door-to-door sampling, direct drug delivery in the cold chain, etc.), to ensure that patients can get the same high-quality diagnosis and treatment resources without having to travel in person.; Study phase: FDA approval. Prognosis: The median survival time of relapsed/refractory ALL is less than 6 months.
Frequently Asked Questions
What is Acute lymphoblastic leukemia (ALL)?
ALL is a malignant blood disease in which lymphocytes proliferate abnormally in the bone marrow. The cure rate of childhood ALL can reach 85-90%, but the prognosis of relapsed/refractory ALL is extremely poor. The prognosis of adult ALL is poor, with a 5-year survival rate of approximately 40%. Core dilemmas: ① Relapsed/refractory ALL is resistant to traditional chemotherapy;② Hematopoietic stem cell transplantation is a radical treatment but has difficulty in matching and transplant-related complications;③ Although CAR-T cell therapy has made breakthroughs in B-ALL, long-term remission rates and toxicity management remain challenges.
What are the symptoms of Acute lymphoblastic leukemia (ALL)?
Malignant proliferation of lymphocytes in bone marrow,Normal hematopoiesis is suppressed,Anemia, bleeding, infection,Most common malignant tumors in children
How is Acute lymphoblastic leukemia (ALL) treated?
CD19/CD22 CAR-T cell therapy: Tisagenlecleucel (Kymriah) and Bresucabtagene autoleucel (Tecartus) have been FDA approved for use in relapsed/refractory B-ALL. Complete remission rates can reach 80-90%.; Blinatumomab: CD19/CD3 dual-specific T cell adapter, used for bridging treatment of relapsed/refractory B-ALL or clearance of minimal residual disease.; allogeneic hematopoietic stem cell transplantation: All-matched siblings or unrelated donor transplantation after myeloablative pretreatment is the only possible method to cure ALL.
What is the prognosis for Acute lymphoblastic leukemia (ALL)?
Median survival for relapsed/refractory ALL is less than 6 months