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How likely is relapse in ALL, and what are the treatment options?
André Baruchel
September 5, 2025
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For World ALL Day 2025, Know ALL spoke to André Baruchel, Hôpital Robert-Debré andHôpital Saint-Louis, Paris, FR. We asked, How likely is relapse in ALL, and what are the treatment options?
During this interview, Dr Baruchel discussed the likelihood of relapse for patients with ALL and the treatment options available in this situation. Baruchel explained that relapse occurs in approximately 15% of children, is more common in adolescents and adults and is confirmed using sensitive techniques such as flow cytometry or molecular testing.1 Treatment then depends on whether relapse occurs early (within 30 months of diagnosis) or late (after 30 months). Late relapses can sometimes be managed with chemotherapy, often combined with immunotherapies such as blinatumomab, and occasionally radiotherapy if the central nervous system is involved. Early relapses are more difficult to treat and typically require more intensive therapy. This may include chemotherapy, targeted antibody–drug conjugates such as inotuzumabozogamicin, and stem cell transplantation.
Recent advances in immunotherapy have added new treatment options for relapsed or refractory ALL. Blinatumomab, a bispecific antibody, directs the patient’s own immune T cells to attack leukemia cells, while CAR T-cell therapy involves genetically modifying a patient’s T cells to recognize and destroy leukemia cells. Baruchel emphasized that while relapse remains a challenge, progress in chemotherapy, immunotherapy, and cellular therapies has significantly improved survival. Many patients who experience a relapse are now able to reach remission again.
References
- Bhatla T, Cooper S, Hogan L. Low-risk relapsed acute lymphoblastic leukemia in children and young adults: What have we learnt and what's next?Leuk Lymphoma.2024;65(10):1398-1404. DOI: 10.1080/10428194.2024.2362408 (https://www.tandfonline.com/doi/full/10.1080/10428194.2024.2362408)
