Side Effect Profiles in Immunotherapy vs Chemotherapy in the Treatment of Pediatric Acute Lymphoblastic Leukemia

Background: Acute lymphoblastic leukemia (ALL) is the most common cancer in children and also one of the most curable, with current cure rates surpassing 90%. Immunotherapy using biologics is an emerging cancer treatment approach that shows significant promise and is generally less toxic than traditional chemotherapy. Due to its lower toxicity compared to chemotherapy, standalone immunotherapy may represent a promising treatment option for pediatric ALL patients. Hypothesis: This review aims to compare acute side effect profiles and chronic complications in chemotherapy versus immunotherapy treatment modalities for pediatric patients with ALL. Immunotherapy is hypothesized to have a more tolerable side effect profile. Methods: Online databases were accessed using various search terms. Eleven articles published between 2015-2023 met the inclusion criteria. The inclusion criteria consisted of English-written, primary research and systematic reviews, and focused on chemotherapy and immunotherapy treatments or adverse effects in pediatric ALL patients. Results: It is demonstrated that blinatumomab use in children and young adults with B-ALL had lower rates of serious adverse events compared to chemotherapy. All adverse effects developed by patients receiving immunotherapy were fully reversible, with no reported deaths related to the adverse effects. Both chemotherapy and immunotherapy have serious side effects; however, chemotherapy-associated effects are typically more severe and chronic. Conclusion: The use of immunotherapy in treating pediatric ALL has the potential to reduce the number and severity of present and future side effects observed in cancer treatment. Immunotherapy may be a more effective treatment option in patients who show resistance to current treatments.