Abstract

We have found little available information in the medical literature on the prevention and treatment of tertiary leukemia or patients' prognosis. We thus conducted a comprehensive literature review using the most recently updated American Society of Hematology guidelines, searching the MEDLINE and PubMed electronic databases by using the key term "progression-free survival (PFS) leukemia" and restricting results to the English language within the last decade. From the initially identified 1,083 papers, we extracted relevant data and treatment recommendations for leukemia patients. Standard treatments like Daunorubicin, Doxorubicin, and Asparaginase for children, adolescents, and young adults (18 to 24 years) have high relapse and complication rates within 5 years of treatment. Blinatumomab and Ibrutinib-Rituximab have higher success rates in PFS and a greater overall survival rate than other chemotherapy options have. Two-year disease-free survival was 39.0% with intensive chemotherapy, whereas it rose to 54.4% with anticancer drugs. Additionally, patients who underwent radiotherapy after relapse exhibited better long-term prevention of another relapse and a higher overall survival rate of 77.7% compared with 11.3% in patients not treated with radiotherapy. In the realm of pediatric leukemias, allogeneic stem cell treatments stand out as the most effective, boasting a superior remission rate. Notably, Tisagenlecleucel, a chimeric antigen receptor (CAR) T-cell therapy, is approved for managing relapses of pediatric leukemias after initial or tertiary remission, with a promising 50% survival rate over 5 or 10 years. Further study on immunotherapies is warranted across diverse age groups from a tertiary prevention perspective.