As additional, more effective, and novel therapies are added to the repertoire of cancer therapy, there are increasing numbers of cancer survivors, and these survivors are living for longer periods of time from diagnosis.

While blinatumomab has been utilized in the setting of relapsed or refractory B-cell acute lymphoblastic leukemia (B-ALL) for years, emerging data has shown promising clinical efficacy with its use as post-remission therapy.

Immunotherapy using antibody drug conjugates, immune check point inhibitors, and chimeric antigen receptor (CAR) T-cells has significantly transformed the treatment landscape of relapsed or refractory hematologic malignancies.

Multiple CAR T-cell therapies are approved for the treatment of certain relapsed or refractory hematologic malignancies with promising clinical outcomes. However, treatment with CAR T-cell therapy is not without risk and can result in severe and potentially fatal toxicities.

Side effects of novel therapies may be severe. Cytokine release syndrome, neurotoxicity, and sinusoidal obstruction syndrome (SOS/VOD) are just some of the serious adverse effects that may occur. With the expanding roles of monoclonal antibodies and CAR-T therapies in acute lymphoblastic leukemia (ALL), pharmacists should be aware of their proper place in therapy and side effect management for patient safety.
As a result of the therapeutic advances and clinical research affecting the management of patients with leukemia, clinicians can benefit by comparing their individual skills of diagnosis, treatment, and management of patients with their peers. This peer interaction is an integral part in enhancing clinical decision-making skills that can improve patient care.
Consolidation therapy is a critical component of ALL therapy, with the goal of eliminating any leukemic cells potentially remaining after induction therapy, further eradicating residual disease. MRD assessment is an essential component of the evaluation of response to therapy in ALL.
Side effects of novel therapies may be severe. Cytokine release syndrome, neurotoxicity, and sinusoidal obstruction syndrome (SOS/VOD) are just some of the serious adverse effects that may occur. With the expanding roles of monoclonal antibodies and CAR-T therapies in acute lymphoblastic leukemia (ALL), pharmacists should be aware of their proper place in therapy and side effect management for patient safety.
Clinicians need education regarding which patients with leukemia are candidates for genetic counseling and testing and how the management of patients with known germline mutations is affected. This knowledge will help clinicians provide these patients with optimal care.
Newer agents used in the treatment of acute lymphoblastic leukemia (ALL) have led to improved clinical outcomes, but are associated with significant toxicities. Clinicians need to be educated on appropriate management approaches for the side effects associated with these new therapies to allow patients to receive maximal benefit and optimal care.

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