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relapse refractory of treatment of acute lymphoblastic leukemia (ALL)
- salvage therapy
- FLAG （fludarabine + cytarabine + G-CSF)
- mitoxantrone 合併cytarabine、
- 高劑量 cytarabine（3 g/m2 Q12H）
多數病人對第二線化療的反應不佳。
- then 👉 allogeneic HSCT
B cell:
- blinatumomab 🦷bli-na-TU-mo-mab
- (CD19 BiTE-bispecific T-cell engager; NEJM2017;376:836)
- inotuzumab 🐷ino-TU-zu-mab
- (CD22 Ab drug conjugate; NEJM2016;375:740)
- tisagenlecleucel and brexucabtagene autoleucel
- (CD19 CAR-T, NEJM 2018;378:449; Lancet 2021;398:491)
- TKI+chemo/steroids (Ph ⊕t(9;22) only)
T cell
- nelarabine
- ± cyclophosphamide
- etoposide
Both B & T cell:
- chemo including
- : high dose cytarabine regimens;
- : clofarabine