Description:
Adolescents and young adult patients (AYA) represent a unique population of patients with acute lymphoblastic leukemia (ALL). AYA patients do not fit squarely into either pediatric or adult cohorts. Unfortunately, AYA patients have been shown to have differential outcomes than older and younger patients with ALL. This educational session will explore describe approaches to therapy, differences between AYA and pediatric patients with ALL, and options for improving outcomes for this patient population. Dr. John Molina will review the current outcomes from AYA patients with B-ALL treated with commonly used pediatric or “pediatric-inspired” regimens in the upfront setting. He will discuss the ongoing clinical trials incorporating immunotherapies into the existing chemotherapy backbones and any available preliminary results, as well as the shift to next generation sequencing (NGS) for measurable residual disease (MRD) assessment. Finally, with the introduction of novel therapies into the upfront setting and improved disease response evaluation, he will review the changing role of hematopoietic stem cell transplant (HSCT) as consolidative therapy for AYA patients achieving a first, complete remission. Dr. Tamara P. Miller will then review the differences between AYA patients and pediatric patients in terms of survival, risks, and barriers to enrollment. She will describe contrasts in genetic risk factors and development of toxicities. She will discuss the range of treatment, trial enrollment and psychosocial challenges that are differ between AYA and pediatric patients. Finally, Dr. Emily Curran will review novel strategies to improve outcomes for AYAs. She will discuss ongoing work to overcome the adverse disease biology that is more common among AYAs with ALL. She will describe ways to leverage technology to improve adherence and try to address psychosocial challenges. Finally, she will review differences in healthcare delivery for AYAs with ALL and need for increased enrollment in clinical trials.