When is HSCT indicated in the treatment of pediatric acute lymphoblastic leukemia (ALL)?

Updated: Jan 03, 2019
  • Author: Vikramjit S Kanwar, MBBS, MBA, MRCP(UK), FAAP; Chief Editor: Jennifer Reikes Willert, MD  more...
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Answer

After reinduction, consolidation treatment is intended to prevent further relapse and achieve long-term cure. For patients with an early relapse HSCT is desirable. Patients with elevated MRD prior to HSCT are more likely to suffer relapse; however, whether multiple cycles of intensive chemotherapy with or without newer agents (such as bortezomib or clofarabine) can ameliorate this risk factor is unclear. [28]

For patients with late relapse the risks of HSCT often outweigh potential benefit, and intensified chemotherapy alone is recommended to achieve long-term remission (>50% of patients). Standard drugs are used in higher doses, along with additional agents, such as etoposide.


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