Lymphocytes, the white blood cells circulating in the body, provide many vital functions to support the immune response. After being generated in bone marrow, lymphocytes move throughout the blood and lymph tissue, where they can regulate immunity, including the anti-tumor immune response.
Like all parts of our biology, cancer can develop in lymphocytes. Acute lymphocytic leukemia, also known as acute lymphoblastic leukemia and abbreviated ALL, is a malignancy that results from the accelerated growth of immature white blood cells called lymphoblasts.
ALL encompasses several subtypes creating substantial challenges to understanding the variable biology and best clinical practices for each classification. To provide substantiated and comprehensive consensus recommendations for the diagnosis, characterization, prognosis, risk factors, and outcomes associated with ALL, the European Working Group for Adult ALL (EWALL) has generated a summary for clinicians. A panel of experts has recently published these consensus recommendations in companion publications in the journal Blood (see articles related to Diagnosis and Management). The authors, led by corresponding author Nicola Gökbuget (Goethe-Universität, Germany), explain that their recommendations intend “to provide guidance for the initial management of adult ALL patients and to define principles as a basis for future collaborative research.”
The working group included 17 panelists from national study groups throughout Europe. Together, the members defined each participant's discussion topics and responsibilities. Authors performed literature searches using PubMed to identify relevant abstracts. The entire group discussed any disagreements arising between members to reach a consensus.
The initial publication (January 31, 2024) focuses on diagnostics and prognostic factors associated with ALL. These guidelines also provide recommendations to streamline standards and evaluations for reporting clinical trial data to standardize reporting for clinical trials.
The follow-up publication (February 2, 2024) provides recommendations for clinical management of ALL in adults. The authors discuss therapeutics, including induction (the first treatment administered and viewed as the best available option) and consolidation (treatments administered following successful treatment that eliminated a tumor) therapies. In addition, the panel recommends therapies specific to unique ALL subtypes.