What Is the Optimal Consolidation Strategy for Adult Philadelphia Chromosome Negative Acute Lymphoblastic Leukemia Patients in First Complete Remission if You Are Not Able to Look for Minimal Residual Disease?

Abstract

Compared to pediatric age group, the prognosis of adult patients with acute lymphoblastic leukemia (ALL) is still poor. Although most adult Philadelphia chromosome negative ALL (Ph- ALL) patients achieve complete remission following induction chemotherapy, half of them are destined to relapse, resulting 40% long term overall survival. Therefore, choosing the best available consolidation strategy in first remission is of utmost importance. Recently, most study groups rely on the evaluation of minimal residual disease (MRD) to guide the consolidation approach. But, in routine practice MRD assessment may be problematic in the management of Ph- ALL. In this review, we summarized the current evidence for optimal consolidation strategy in adult Ph- ALL in first remission, if facilities for MRD analysis are not in place.