Treatment of Acute Lymphoblastic Leukemia with Philadelphia Chromosome (BCR::ABL1 Fusion Gene)
A subset of adults with acute lymphoblastic leukemia (ALL) carries the Philadelphia chromosome — a chromosomal alteration that creates the BCR::ABL1 fusion gene in the leukemia cells. This subtype, Ph+ ALL, defines a distinct clinical scenario that requires a specific treatment approach.
Clinical scenario
The leukemia cells harbour the Philadelphia chromosome (BCR::ABL1 fusion gene). About 25% of adults with ALL are identified with this subtype, known as Ph-positive ALL. The presence of this chromosomal alteration directly shapes treatment selection throughout all phases of care.
Treatment approach — partial overview
In Ph+ ALL, treatment involves the use of a targeted oral agent from a specific drug class that acts on the BCR::ABL1 fusion protein. This agent is continued during consolidation and maintenance phases of therapy, and may be recommended for extended use beyond transplant decisions in first complete remission.
Full regimen details, sequencing, and clinical decision logic are in the complete protocol ↓
References
- About 25 percent of adults with ALL have a subtype called Philadelphia chromosome-positive ALL (also known as "Ph+ ALL" or "Ph-positive ALL").
- This chromosomal alteration creates a fusion gene called BCR::ABL1.
- For patients with Ph+ ALL, a tyrosine kinase inhibitor (TKI) is usually continued.
- For patients with Ph+ ALL, a tyrosine kinase inhibitor (TKI) is often continued during the maintenance phase as well.
- Generally, TKI therapy is recommended to continue indefinitely for patients who do not receive a transplant in first complete remission.
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