Advances in Immunotherapy of Acute Lymphoblastic Leukemia(ALL)
Acute lymphoblastic leukemia(ALL)is a blood cancer that primarily affects children and adults.ALL is due to the malig-nant proliferation of lymphoid precursor cells that invade the bone marrow and can spread to extramedullary sites.The prognosis for pedi-atric ALL patients has significantly improved over the past few decades,however,certain subgroups of pediatric ALL,particularly those with relapsed and refractory disease,still have poor outcomes.Further increasing in the intensity of conventional chemotherapy would be associated with significant adverse effects in these poor prognosis subgroups.In addition,the use of multiple cytotoxic drugs in combina-tion therapy can lead to multiple long-term complications among cured patients,including multi-organ dysfunction,second cancers,mental deterioration,and social and psychological issues.To date,the survival rate in adults continues to be poor,with high relapse rates and unsatisfactory cure rates.Therefore,it is necessary to explore more effective and safer treatment methods to improve the treat-ment effect of ALL patients.Significant advance has been made in targeted therapy with immunotherapy and molecular therapeutics in the past 10 years.For immunotherapy,the approval of antibody-based therapy(Blinatumomab and Inotuzumab ozogamicin)and T cell-based therapy(Tisagenlecleucel)by the US FDA has significantly improved the response rate and outcomes in patients with relapsed/refractory B-ALL.Incorporating effective immunotherapy into ALL therapy would enable reduce the intensity of conventional chemo-therapy,reduce associated toxicity,and further improve the survival rate and quality of life for patients with ALL.In this review,we will discuss novel therapeutic options including bispecific antibodies,antibody-drug conjugates,chimeric antigen receptor(CAR)-based therapies,to provide new ideas and directions for the treatment of ALL patients.
Acute lymphoblastic leukemia(ALL)ImmunotherapyChimeric antigen receptor T cells therapyAntibody-drug con-jugatesBispecific antibodies