Journal
CANCER AND METASTASIS REVIEWS
Volume 39, Issue 1, Pages 173-187Publisher
SPRINGER
DOI: 10.1007/s10555-020-09848-z
Keywords
Central nervous system; Acute lymphoblastic leukemia; CNS involvement; Blood-brain-barrier; Tumor dormancy; Immunotherapy
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Funding
- Projekt DEAL
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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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