Treatment of relapsed and refractory acute lymphoblastic leukemia

Relapse is a major cause of mortality in adult acute lymphoblastic leukemia. Prognosis of patients with relapsed and refractory disease is very poor. Treatment should be focused on achievement of complete remission (CR) followed by allogeneic hematopoietic stem cell transplantation. Conventional chemotherapy results in relatively high CR rate, however, duration of the response is short. The use of humoral and cellular forms of immunotherapy may markedly improve the prognosis. The efficacy of this kind of therapy requires confirmation in further clinical studies