Guidelines Issued for Management of Acute Lymphoblastic Leukemia in Teens, Young Adults

MONDAY, Feb. 23, 2026 (HealthDay News) — In guidelines issued by the American Society of Hematology and published online Feb. 11 in Blood Advances, recommendations are presented for frontline management of acute lymphoblastic leukemia (ALL) in adolescents and young adults (AYA), as well as management of relapsed or refractory disease in this population.

Adam S. DuVall, M.D., M.P.H., from the University of Chicago Medical Center, and colleagues developed evidence-based guidelines for frontline management of ALL in AYAs. Fifteen recommendations and several good practice statements were established. Compared with more traditional adult-inspired protocols, requiring significant supportive care and close follow-up, the authors recommend pediatric-inspired regimens containing asparaginase as frontline therapy. In first remission, allogeneic hematopoietic stem cell transplantation (allo-HSCT) is not routinely recommended, but it may be indicated for higher-risk subsets or for those with suboptimal responses to initial therapy. Use of targeted agents is increasingly supported in frontline therapy.

Kristen O”Dwyer, M.D., from the University of Rochester School of Medicine and Dentistry in New York, and colleagues developed evidence-based guidelines for AYA with relapsed or refractory ALL. Eight recommendations and one research-only recommendation covering remission reinduction and consolidation were established. The authors focused on immunotherapy, targeted therapies, allo-HSCT, and central nervous system-directed therapy. They recommend use of blinatumomab and/or inotuzumab over chemotherapy for reinduction.

“There are two huge challenges for treating this population — the speed at which the field is evolving and the need to bridge pediatric and adult oncology approaches to treatment,” coauthor Sumit Gupta, M.D., from The Hospital for Sick Children in Toronto, said in a statement. “These guidelines meet both challenges, and our hope is that they will spur additional collaboration between adult and pediatric oncologists to effectively treat these patients.”

Abstract/Full Text – DuVall (subscription or payment may be required)

Abstract/Full Text – O”Dwyer (subscription or payment may be required)