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Open Access 01-03-2020 | Acute Lymphoblastic Leukemia

Involvement of the central nervous system in acute lymphoblastic leukemia: opinions on molecular mechanisms and clinical implications based on recent data

Authors: Lennart Lenk, Ameera Alsadeq, Denis M. Schewe

Published in: Cancer and Metastasis Reviews | Issue 1/2020

Abstract

Acute lymphoblastic leukemia (ALL) is the most common childhood cancer. One of the major clinical challenges is adequate diagnosis and treatment of central nervous system (CNS) involvement in this disease. Intriguingly, there is little solid evidence on the mechanisms sustaining CNS disease in ALL. Here, we present and discuss recent data on this topic, which are mainly derived from preclinical model systems. We thereby highlight sites and routes of leukemic CNS infiltration, cellular features promoting infiltration and survival of leukemic cells in a presumably hostile niche, and dormancy as a potential mechanism of survival and relapse in CNS leukemia. We also focus on the impact of ALL cytogenetic subtypes on features associated with a particular CNS tropism. Finally, we speculate on new perspectives in the treatment of ALL in the CNS, including ideas on the impact of novel immunotherapies.

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Title: Involvement of the central nervous system in acute lymphoblastic leukemia: opinions on molecular mechanisms and clinical implications based on recent data
Authors: Lennart Lenk
Ameera Alsadeq
Denis M. Schewe
Publication date: 01-03-2020
Publisher: Springer US
Keywords: Acute Lymphoblastic Leukemia
Leukemia
Published in: Cancer and Metastasis Reviews / Issue 1/2020
Print ISSN: 0167-7659
Electronic ISSN: 1573-7233
DOI: https://doi.org/10.1007/s10555-020-09848-z

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