Hematopoietic Stem Cell Transplantation in Pediatric Acute Lymphoblastic Leukemia

Current Hematologic Malignancy Reports
Pietro MerliF Locatelli

Abstract

The remarkable improvement in the prognosis of children with acute lymphoblastic leukemia (ALL) has been mainly achieved through the administration of risk-adapted therapy, including allogeneic hematopoietic stem cell transplantation (HSCT). This paper reviews the current indications to HSCT in ALL children, as well as the type of donor and conditioning regimens commonly used. Finally, it will focus on future challenges in immunotherapy. As our comprehension of disease-specific risk factors improves, indications to HSCT continue to evolve. Future studies will answer the year-old question on the best conditioning regimen to be used in this setting, while a recent randomized controlled study fixed the optimal anti-thymocyte globulin dose in unrelated donor HSCT. HSCT, the oldest immunotherapy used in clinical practice, still represents the gold standard consolidation treatment for a number of pediatric patients with high-risk/relapsed ALL. New immunotherapies hold the promise of further improving outcomes in this setting.

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Citations

Apr 15, 2020·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Nirali N ShahTerry J Fry
Apr 30, 2020·Journal of Cancer Research and Clinical Oncology·Victoria RuscherPablo Hernáiz Driever
Jan 31, 2020·Current Oncology Reports·Valentin BarsanKara L Davis
Dec 5, 2020·Hematology·Caroline Diorio, Shannon L Maude
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May 6, 2021·Journal of Personalized Medicine·Wanda LattanziOrnella Parolini
Oct 6, 2021·Blood Advances·Riccardo MasettiAndrea Pession

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