Novel strategies to prevent and overcome relapse after allogeneic hematopoietic cell transplantation in acute lymphoblastic leukemia

• Published in: Frontiers in immunology Vol. 14; p. 1191912
• Main Authors: Hodroj, Mohammad Hassan, Abou Dalle, Iman, Moukalled, Nour, El Cheikh, Jean, Mohty, Mohamad, Bazarbachi, Ali
• Format: Journal Article
• Language: English
• Published: Switzerland Frontiers Media S.A 08.06.2023
• Subjects: acute lymphoblastic leukemia; allogeneic stem cell transplant; antibody drug conjugates; bispecific antibodies; Hematopoietic Stem Cell Transplantation - adverse effects; Humans; Immunology; Inotuzumab Ozogamicin - therapeutic use; Precursor B-Cell Lymphoblastic Leukemia-Lymphoma; Precursor Cell Lymphoblastic Leukemia-Lymphoma - etiology; Recurrence; relapse; tyrosine kinase inhibitors; tyrosine kinase inhibitors; antibody drug conjugates; bispecific antibodies; acute lymphoblastic leukemia; relapse; allogeneic stem cell transplant
• ISSN: 1664-3224; 1664-3224
• DOI: 10.3389/fimmu.2023.1191912

The outcome of B-cell acute lymphoblastic leukemia (B-ALL) has improved over time with the incorporation of multi-agent chemotherapy in the treatment landscape as well as the recent approval of immunotherapeutic agents allowing a larger proportion of patients to undergo allogeneic hematopoietic cell transplantation (allo-HCT) which is still considered a potential curative approach. However, relapse post-transplant is still occurring and constitutes a common cause of treatment failure in B-ALL. The present review aims to discuss the novel strategies and therapies used to prevent and overcome relapse post allo-HCT in patients with ALL, focusing on the role of tyrosine kinase inhibitors in Philadelphia chromosome positive B-ALL, the role of innovative agents such as blinatumomab and inotuzumab ozogamicin, and finally the role of cellular therapy.