Modern Treatment Methods for Acute Leukemias: Chemotherapy, Targeted Therapy, and Cellular Immunotherapy

Аннотация

Acute leukemias are among the most severe malignant diseases of the hematopoietic system. Despite significant progress in diagnosis and treatment, they remain an important medical and social problem. Conventional combination chemotherapy remains the foundation of treatment; however, its use is limited by toxicity, the development of drug resistance, and the risk of relapse. In recent years, the treatment of acute leukemias has changed considerably owing to the introduction of molecular genetic diagnostics, targeted drugs, monoclonal and bispecific antibodies, CAR T-cell therapy, and hematopoietic stem cell transplantation. The aim of this study is to analyze modern treatment methods for acute lymphoblastic leukemia and acute myeloid leukemia, as well as to evaluate their advantages, limitations, and prospects. The paper examines conventional chemotherapy, tyrosine kinase inhibitors, FLT3 and IDH inhibitors, drugs targeting the BCL-2 protein, monoclonal and bispecific antibodies, antibody–drug conjugates, CAR T-cell therapy, and hematopoietic stem cell transplantation. Particular attention is paid to the importance of measurable residual disease and treatment personalization. The modern approach to the treatment of acute leukemias is based on the combination of clinical, immunological, and molecular genetic characteristics of the disease. A promising direction is the transition from universal chemotherapy to risk-adapted treatment combinations, which may improve treatment effectiveness and reduce toxicity.