New treatments for ALL
- Vincristine liposomal: this lowers toxicity, though also creates more neutropenia when compared to conventional vincristine.
- Cytarabine liposomal: administered intrathecally, though this drug increases neurotoxicity.
- L-asparaginase encapsulated in red blood cells (GRASPA) and pegylated.
- Inotuzumab: This is a monoclonal antibody targeting a protein that the disease cells have, known as CD22, which has been shown to have certain activity in relapse.
- Blinatumomab: This is a molecule with the capacity to bring T cells into contact with leukemia cells in the area surrounding a tumor cell. Activation of the T cell in the proximity of the tumor cells allows the tumor cell to be destroyed.
- CARs are patient immune cells that have been manipulated to target a relatively specific target in tumor cells. They are very effective in acute lymphoid leukemia and chronic lymphocytic leukemia. This technology is developing very rapidly, though there are still substantial technical and economic barriers that hinder progress.
- Many other drugs are being developed which may be applied to specific subtypes of ALL that exhibit concrete molecular alterations e.g., menin-MLL inhibitors , via JAK, IKARON, and mTOR. This type of treatment is based on specific alterations present in each patient. The treatment is begun once certain changes are detected when there is a drug available to neutralize the pernicious effect of the alteration.