Treatment of refractory and recurrent T-lymphoblastic lymphomas from progenitor cells in children and adolescents: current problem state and future perspectives

Introduction . Despite the successes achieved in the treatment of lymphoblastic lymphomas from progenitor cells (LBL), an important task in improving survival rates in the group of patients with T-cell lymphoblastic lymphomas (T-LBL) remains. The group of special unfavorable prognosis consists of patients with relapses and refractory forms (r/r) of T-LBL. Aim : to present a literature review on the use of targeted and immune drugs, as well as cellular and transplant methods in the treatment of r/r T-LBL. Main findings . Modern clinical onco-hematology has a broad spectrum of methods for the treatment of r/r T-LBL, including intensive chemotherapy, targeted, transplant and CAR-T technologies, but even a combination of these methods, currently, does not make it possible to achieve optimistic results in this prognostically unfavorable group of patients. It is possible that the creation of targeted drugs focused on signaling pathways (NOTCH, PI3K/ACT/mTOR, JAK/STAT and MAPK) with modern therapeutic potential could improve patient survival rates.