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The Treatment of Adults with Acute Lymphoblastic Leukemia

Correspondence: Adele K. Fielding, MB BS, PhD, Royal Free and University College Medical School, Rowland Hill St., London, NW3 2PF, United Kingdom; e-mail: a.fielding{at}medsch.ucl.ac.uk.

Abstract

Despite the relatively low incidence of acute lymphoblastic leukemia (ALL) in adults, large national and international collaborations have recently improved our understanding of how to treat ALL in adults. This article documents and examines the current evidence base for a "state of the art" therapy in both Philadelphia chromosome–negative and –positive adult ALL. The article comments upon areas of therapeutic debate, such as the role of bone marrow transplantation. In particular, the controversial subject of whether the superior outcome seen in younger patients is predicated on disease biology or therapeutic strategy is examined closely. Promising approaches under development are also discussed.

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