Thrombosis in ALL: A risk without clear mitigation

Abstract

In this issue of Blood, Orvain and colleagues, on behalf of the GRAALL, the French cooperative group leukemia study group, present data that help to define more clearly the incidence and risk factors for thromboembolism in adults receiving treatment on a pediatric-inspired regimen, GRAALL-2005.1,2 In recent years, a number of prospective trials have demonstrated improved survival rates for young adults treated with pediatric-inspired regimens that contain frequent dosing of asparaginase and glucocorticoids, both known to be associated with an increased risk of thromboembolic events.3-6 One of the challenges to further improving treatment outcomes in adult patients is to understand (and, one hopes, to modify) the toxicities that occur more frequently in the adult population treated with these pediatric-inspired regimens.