Current therapy of acute lymphoblastic leukemia in adults

Acute lymphoblastic leukemia (ALL) is the most frequent malignancy in childhood and also accounts for 20% of acute leukemia in adulthood. It is one of the few disseminated malignant diseases which can be cured with chemotherapy alone. In the past decades considerable progress has been made in terms of characterization of the disease. Biological subgroups and risk groups with different clinical courses have been characterized. This achievement formed the basis for contemporary, individualized and risk-adapted treatment protocols. Approximately 90% of adult ALL patients nowadays achieve complete remission and cure rates have been improved from less than 10% to more than 50% over the past 30 years. The improved treatment results are essentially due to optimized chemotherapy and supportive care, integration of stem cell transplantation in first line therapy and improved risk stratification. More recently, individual treatment modifications based on minimal residual disease and targeted therapies, such as tyrosine kinase inhibitors in Ph/BCR-ABL-positive ALL have been developed.