ASH Releases Guidelines for ALL Treatment in Youth

New evidence-based recommendations aim to improve outcomes for adolescents and young adults with acute lymphoblastic leukemia

Published on Feb. 11, 2026

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The American Society of Hematology (ASH) has released new guidelines for the frontline management and treatment of relapsed or refractory disease in adolescents and young adults (AYAs) with acute lymphoblastic leukemia (ALL). The guidelines, developed by pediatric and adult experts in collaboration with patient representatives, provide standardized, evidence-based approaches to improve care and outcomes for this vulnerable patient population.

Why it matters

Treating ALL in AYAs is complex, as this age group does not align neatly with standard pediatric or adult treatment regimens. These new guidelines aim to address this gap by outlining best practices and providing vital standardization to clinical approaches, ultimately improving patient care and outcomes.

The details

The frontline management guidelines consist of 15 recommendations, including endorsing pediatric-inspired regimens over traditional adult-inspired protocols and the use of asparaginase as a cornerstone of therapy. The guidelines for relapsed or refractory disease include 8 recommendations, such as supporting immunotherapy over traditional chemotherapy approaches and the use of allogeneic transplant in certain cases. Both sets of guidelines highlight the need for additional research, including clinical trials directly comparing immunotherapies and studies to determine if more patients can forego transplant.

  • The guidelines were published on February 11, 2026 in the ASH's peer-reviewed journal Blood Advances.

The players

American Society of Hematology (ASH)

A professional medical association dedicated to the study and treatment of blood disorders.

Robert Negrin, MD

ASH President.

Wendy Stock, MD

Anjuli Seth Nayak Professor of Medicine at the University of Chicago and co-chair of the ASH Guidelines for Frontline Management of ALL in AYAs.

Sumit Gupta, MD, PhD

Professor in the department of paediatrics at the University of Toronto, head of the leukemia/lymphoma section at the Hospital for Sick Children, and co-chair of the ASH Guidelines for Management of Relapsed and Refractory Disease in AYAs with ALL.

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What they’re saying

“Caring for these individuals is complex given the unique challenges associated with their age group, which doesn't align neatly with standard pediatric or adult treatment regimens. These guidelines aim to address this gap by outlining best treatment practices and providing vital standardization to clinical approaches to improve patient care.”

— Robert Negrin, MD, ASH President (Mirage News)

“These guidelines address many of the challenging nuances to treating ALL in AYAs, including management of chemotherapy effects, psychosocial support, and survivorship, including fertility concerns. Additionally, they highlight that we're in a period of great progress in terms of new approaches to treating and monitoring this disease.”

— Wendy Stock, MD, Anjuli Seth Nayak Professor of Medicine at the University of Chicago and co-chair of the ASH Guidelines for Frontline Management of ALL in AYAs (Mirage News)

“There are two huge challenges for treating this population – the speed at which the field is evolving and the need to bridge pediatric and adult oncology approaches to treatment. These guidelines meet both challenges, and our hope is that they will spur additional collaboration between adult and pediatric oncologists to effectively treat these patients.”

— Sumit Gupta, MD, PhD, Professor in the department of paediatrics at the University of Toronto, head of the leukemia/lymphoma section at the Hospital for Sick Children, and co-chair of the ASH Guidelines for Management of Relapsed and Refractory Disease in AYAs with ALL (Mirage News)

What’s next

The guidelines highlight the need for additional research, including clinical trials directly comparing immunotherapies and studies to determine whether additional patients can forego transplant without compromising outcomes.

The takeaway

These new evidence-based guidelines from ASH aim to improve care and outcomes for adolescents and young adults with acute lymphoblastic leukemia by providing standardized, collaborative approaches to treatment that bridge pediatric and adult oncology practices.