Remission induction therapy

Sixty percent to 80% of adults with ALL usually achieve a complete remission after appropriate induction therapy. Appropriate initial treatment, usually consisting of a regimen that includes the combination of vincristine, prednisone, and an anthracycline, with or without asparaginase, results in a complete response rate of up to 80%. In patients with Ph-positive ALL, the remission rate is generally greater than 90% when standard induction regimens are combined with BCR::ABL1 tyrosine kinase inhibitors. In the largest study published to date of Ph-positive ALL patients, 1,913 adult patients with ALL had a 5-year overall survival (OS) rate of 39%.[1]

Patients who experience a relapse after remission usually die within 1 year, even if a second complete remission is achieved. If there are appropriate available donors and if the patient is younger than 55 years, bone marrow transplant may be considered.[2] Transplant centers performing five or fewer transplants annually usually have poorer results than larger centers.[3] If allogeneic transplant is considered, it is recommended to avoid transfusions with blood products from a potential donor.[4-10]