Diagnostic and treatment of adult Philadelphia chromosome-positive acute lymphoblastic leukemia.

Abstract

The outcome of adult patients with Philadelphia chromosome-positive (Ph⁺) acute lymphoblastic leukemia (ALL) has improved substantially with the introduction of tyrosine kinase inhibitors (TKIs). TKIs are now integral components of therapy for Ph⁺ ALL. The current consensus is that they improve patient outcomes compared with historical control patients treated with chemotherapy alone, and increase the number of patients able to receive stem cell transplant. New challenges have emerged with respect to induction of resistance mainly via Abelson tyrosine kinase mutations. Several novel kinase inhibitors with significantly more potent antileukemic activity are currently being developed. Furthermore novel immune therapies, which recruit or modify patient's own T cells to fight leukemic cells, are being developed and could find an important place in Ph⁺ ALL therapy by few years. In this article, we reviewed treatment approaches in adults with Ph⁺ ALL with a focus on TKIs and combined chemotherapy regimens.