New therapeutic options in the treatment of patients with relapsed/refractory B-cell acute lymphoblastic leukemia

Summary. Acute Lymphoblastic Leukemia (ALL) is a heterogeneous hematologic disease characterized by the proliferation of immature lymphoid cells in the bone marrow, peripheral blood, and other organs. According to the classification of the World Health Organization in 2016, B-lymphoblastic leukemia and T-lymphoblastic leukemia are distinguished with following their subclassification based on molecular characteristics. One of the problems of ALL treatment is the development of relapse after primary ALL therapy, which causes a poor prognosis in this group of patients. In the context of 2023 recommendations of the National Comprehensive Cancer Network (NCCN), special attention in ALL treatment belongs to immunotherapy with monoclonal antibodies, the purpose of which has fundamentally changed the paradigm of treatment of adults and children with B-ALL. One of the representatives of this group of drugs is inotuzumab ozogamicin (Besponza), which is a conjugate of a monoclonal antibody with a drug against the CD22 antigen. Inotuzumab ozogamicin has demonstrated significant activity in relapsed/refractory (r/r) B-cell ALL in monotherapy and combination chemotherapy regimens in adult patients, as demonstrated in a series of clinical trials. Therefore, in recent years, new therapeutic options have appeared in the treatment of chronic B-ALL, which will improve the survival of this group of patients.

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