What is the role of allogeneic transplantation in the treatment of acute lymphoblastic leukemia (ALL)?

Updated: Jul 17, 2018
  • Author: Karen Seiter, MD; Chief Editor: Emmanuel C Besa, MD  more...
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Answer

In current practice, most adult patients (except the most elderly and those with significant comorbidities) are offered allogeneic transplantation in first remission. The use of alternative donors (including matched unrelated donors, cord blood, and haploidentical donors) allows for most patients to have an appropriate donor.

However, as nontransplant therapies have improved, controversy has arisen as to whether transplantaiton is always needed. Examples include the addition of tyrosine kinase inhibitors in Philadelphia chromosome–positive (Ph+) ALL, and the addition of rituximab in mature B-cell ALL.


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