Evidence map›Paper›PMID 42437816›Full record

ReviewCurrent hematologic malignancy reports2026

Breaching the Blood-Brain Barrier: Evolving Strategies for Central Nervous System Disease in Adult Acute Lymphoblastic Leukemia.

Liesl S Eibschutz, Samuel Crow, Caroline Tatum, Daniel Reed, Michael Keng

Abstract readReview
In one paragraph

Review in Current hematologic malignancy reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–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

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Liesl S EibschutzUniversity of Virginia Comprehensive Cancer Center, 1240 Lee St., Charlottesville, VA, 22903, USA.
Samuel CrowUniversity of Virginia Comprehensive Cancer Center, 1240 Lee St., Charlottesville, VA, 22903, USA.
Caroline TatumUniversity of Virginia Comprehensive Cancer Center, 1240 Lee St., Charlottesville, VA, 22903, USA.
Daniel ReedUniversity of Virginia Comprehensive Cancer Center, 1240 Lee St., Charlottesville, VA, 22903, USA.
Michael KengUniversity of Virginia Comprehensive Cancer Center, 1240 Lee St., Charlottesville, VA, 22903, USA. mk2pv@uvahealth.org.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purpose of reviewCentral nervous system (CNS) involvement in adult acute lymphoblastic leukemia (ALL) remains a critical determinant of treatment failure and long-term survival. This review provides a comprehensive, evidence-based framework for the diagnosis, risk stratification, prophylaxis, and treatment of CNS disease in adult ALL, with emphasis on the evolving challenges introduced by immunotherapy-based and chemotherapy-sparing regimens and presents our institutional approach to CNS-directed therapy. RECENT

findingsModern CNS prophylaxis combining intrathecal chemotherapy with CNS-penetrating systemic agents has dramatically reduced CNS relapse rates, yet diagnostic and therapeutic limitations persist. The increasing use of immunotherapies, such as blinatumomab and inotuzumab ozogamicin, has improved systemic disease control, while CNS relapse is increasingly recognized in this context, particularly among heavily pretreated patients. This pattern likely reflects multiple factors, including limited CNS penetration, improved disease control that unmasks previously subclinical CNS involvement, and the high-risk biology of relapsed/refractory disease. In contrast, CD19-directed CAR T-cell therapies have demonstrated meaningful activity in CNS disease, while investigational strategies targeting leukemic trafficking pathways and IL-15 signaling offer additional preclinical promise. As adult ALL treatment has shifted toward chemotherapy-sparing regimens, new concerns have emerged regarding disease control within the CNS compartment. Durable remission will require integration of rigorous intrathecal prophylaxis, risk-adapted systemic therapy, and novel agents capable of penetrating the CNS microenvironment into every treatment algorithm.

Indexed as

Blood-Brain BarrierCentral Nervous System NeoplasmsPrecursor Cell Lymphoblastic Leukemia-LymphomaAdultAntineoplastic Combined Chemotherapy ProtocolsHumansAcute lymphoblastic leukemiaBlinatumomabCAR T-cell therapyCentral nervous systemCNS prophylaxisInotuzumab ozogamicinIntrathecal chemotherapy

Identifiers

PMID42437816
PMCPMC13357447

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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 Socratic graph.