Philadelphia-Positive Acute Lymphoblastic Leukemia: Current Treatment Options

The Philadelphia chromosome (Ph), t(9;22), is seen in about 20 % to 30 % of adults diagnosed with acute lymphoblastic leukemia (ALL). It has been associated with poorer prognosis compared with Ph-negative ALL. Tyrosine kinase inhibitors (TKIs) targeting the BCR-ABL oncogenic protein from this transl...

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Bibliographic Details
Published in:Current oncology reports 2012-10, Vol.14 (5), p.387-394
Main Authors: Liu-Dumlao, Theresa, Kantarjian, Hagop, Thomas, Deborah A., O’Brien, Susan, Ravandi, Farhad
Format: Article
Language:English
Subjects:
Aniline Compounds - therapeutic use
Antineoplastic Agents - therapeutic use
Benzamides
Dasatinib
Humans
Imatinib Mesylate
Imidazoles - therapeutic use
Leukemia (A Aguayo
Medicine
Medicine & Public Health
Neoplasm, Residual - diagnosis
Nitriles - therapeutic use
Oncology
Piperazines - therapeutic use
Precursor Cell Lymphoblastic Leukemia-Lymphoma - diagnosis
Precursor Cell Lymphoblastic Leukemia-Lymphoma - drug therapy
Precursor Cell Lymphoblastic Leukemia-Lymphoma - surgery
Protein Kinase Inhibitors - therapeutic use
Pyridazines - therapeutic use
Pyrimidines - therapeutic use
Quinolines - therapeutic use
Section Editor
Stem Cell Transplantation
Thiazoles - therapeutic use
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Summary:The Philadelphia chromosome (Ph), t(9;22), is seen in about 20 % to 30 % of adults diagnosed with acute lymphoblastic leukemia (ALL). It has been associated with poorer prognosis compared with Ph-negative ALL. Tyrosine kinase inhibitors (TKIs) targeting the BCR-ABL oncogenic protein from this translocation have been incorporated into treatment regimens used to treat patients with Ph-positive ALL. Imatinib has been the most widely used TKI with several published trials showing it produced better outcomes when combined with chemotherapy. Dasatinib, a more potent inhibitor than imatinib, has also been evaluated with promising results. However, relapses still occur at a high rate, and allogeneic stem cell transplant is considered, so far, a better curative option in first remission. Additional strategies have also included incorporation of TKIs in the post-transplant setting and the use of newer third generation TKIs. This review provides an update on emerging therapies for adults with Ph-positive ALL.
ISSN:1523-3790
1534-6269
DOI:10.1007/s11912-012-0247-7