Evidence map›Paper›PMID 41670624›Full record

GuidelineBlood advances2026

American Society of Hematology 2026 guidelines for management of relapsed/refractory acute lymphoblastic leukemia in adolescents and young adults.

Kristen O'Dwyer, Lena E Winestone, Matthew C Cheung, Lydia Benitez, Barbara Buldini, Peter D Cole, Moussab Damlaj, Bhagirathbhai Dholaria, Ajoy L Dias, Alexander Dils and 17 more

Abstract readPractice Guideline
PubMed Full text at PMC Publisher
In one paragraph

Guideline in Blood advances, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Guideline
  2. Trial
  3. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

27 authors.

Kristen O'DwyerWilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY.ORCID 0000-0001-8517-8198
Lena E WinestoneDivision of Allergy, Immunology, and Blood & Marrow Transplant, University of California, San Francisco Benioff Children's Hospitals, San Francisco, CA.ORCID 0000-0001-9982-1594
Matthew C CheungDivision of Medical Oncology and Hematology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.ORCID 0000-0003-3193-5872
Lydia BenitezDepartment of Clinical Pharmacy, University of Michigan College of Pharmacy, Ann Arbor, MI.
Barbara BuldiniPediatric Hematology, Oncology and Stem Cell Transplant Division, Maternal and Child Health Department, Padua University, Padua, Italy.
Peter D ColeDivision of Pediatric Hematology/Oncology, Department of Pediatrics, Rutgers Cancer Institute, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ.ORCID 0000-0002-3525-8015
Moussab DamlajSheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates.
Bhagirathbhai DholariaVanderbilt University Medical Center, Nashville, TN.ORCID 0000-0003-2371-3655
Ajoy L DiasImmune Deficiency Cellular Therapy Program, Center for Cancer Research, National Cancer Institute, Bethesda, MD.
Alexander DilsDepartment of Internal Medicine, University of Michigan Medicine, Ann Arbor, MI.ORCID 0000-0002-9052-4726
Michelle FritschTexas Children's Cancer and Hematology Center, Houston, TX.
John GreerVanderbilt University Medical Center, Nashville, TN.
Brandon Hayes-LattinOregon Health and Science University Knight Cancer Institute, Portland, OR.ORCID 0000-0002-4380-4573
Meret HenryDivision of Hematology/Oncology/Bone Marrow Transplantation, Department of Pediatrics, Children's Hospital of Michigan, Detroit, MI.
Aaron JaffeHalethorpe, MD.
Omer JamyDivision of Hematology and Oncology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL.ORCID 0000-0003-2411-4742
Partow KebriaeiThe University of Texas MD Anderson Cancer Center, Houston, TX.
Ilayna MehrtensBiological Sciences Division, Department of Psychiatry and Behavioral Neuroscience, Section of Child and Adolescent Psychiatry, University of Chicago Medicine, Chicago, IL.ORCID 0009-0008-5094-3468
Nirali N ShahPediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD.ORCID 0000-0002-8474-9080
Lindsay WildeDivision of Hematologic Malignancies, Department of Medical Oncology, Sidney Kimmel Comprehensive Cancer Center at Thomas Jefferson University, Philadelphia, PA.
Patricia A YoungDivision of Hematology/Oncology, Department of Medicine, University of California, Los Angeles, CA.ORCID 0000-0002-2161-9377
Htun Ja MaiCenter for Evidence Synthesis in Health, Brown University School of Public Health, Providence, RI.ORCID 0009-0004-1357-1088
Ghid KanaanCenter for Evidence Synthesis in Health, Brown University School of Public Health, Providence, RI.
Yuliia SeredaCenter for Evidence Synthesis in Health, Brown University School of Public Health, Providence, RI.ORCID 0000-0002-4017-4561
Ian J SaldanhaCenter for Clinical Trials and Evidence Synthesis, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.ORCID 0000-0002-2062-3382
Ethan M BalkCenter for Evidence Synthesis in Health, Brown University School of Public Health, Providence, RI.ORCID 0000-0002-4376-7290
Sumit GuptaDivision of Hematology/Oncology, The Hospital for Sick Children, Toronto, ON, Canada.ORCID 0000-0003-1334-3670

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAdolescents and young adults (AYAs) with relapsed/refractory acute lymphoblastic leukemia (ALL) face unique challenges as they experience greater treatment resistance, higher rates of toxicity, and present at a specific life stage with distinct priorities.

objectiveThese evidence-based guidelines of the American Society of Hematology (ASH) are intended to support clinicians, patients, and other health care professionals in their decisions about management of AYAs with relapsed/refractory ALL.

methodsASH formed a multidisciplinary guideline panel including hematologists, AYA psychosocial care specialists, pharmacists, methodologists, and patient representatives with efforts to minimize bias from conflicts of interest. An evidence review team at Brown University supported guideline development, including performing systematic evidence reviews up to November 2023. The panel prioritized clinical questions and outcomes according to importance for clinicians and patients. The panel used Grading of Recommendations Assessment, Development and Evaluation (GRADE), including GRADE Evidence-to-Decision frameworks, to assess evidence and make recommendations, which were subject to public comment.

resultsThe panel agreed on 8 recommendations and 1 research-only recommendation, covering remission reinduction and consolidation. They focused on the following treatment modalities: immunotherapy, targeted therapies, allogeneic hematopoietic stem cell transplant, and central nervous system (CNS)-directed therapy.

conclusionsKey recommendations include the use of blinatumomab and/or inotuzumab over chemotherapy for reinduction. Additional management of ALL subsets (T-cell ALL), CNS relapse, and the role of consolidation with allogeneic transplant are addressed. Future research should evaluate these approaches with special attention to the unique AYA population, and should evaluate quality of life outcomes.

Indexed as

Precursor Cell Lymphoblastic Leukemia-LymphomaAdolescentDisease ManagementDrug Resistance, NeoplasmHematologyHumansRecurrenceSocieties, MedicalYoung Adult

Identifiers

PMID41670624
PMCPMC13366310

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.