Philadelphia chromosome-positive ALL (Ph+ ALL) is a molecularly defined subtype of acute lymphoblastic leukemia. Its identification by karyotyping or molecular genetics is the essential first step, as it directly determines the induction approach and treatment goals.
This protocol applies to patients with acute lymphoblastic leukemia in whom the Philadelphia chromosome (BCR::ABL1 fusion) has been confirmed by karyotyping and/or molecular genetics. Establishing this molecular diagnosis is the necessary prerequisite for selecting the appropriate treatment strategy.
Induction in Ph+ ALL is built around the early initiation of a tyrosine-kinase inhibitor, as delays reduce its efficacy; CNS-prophylaxis is mandatory. The specific agents, combinations, and sequencing are fully detailed in the protocol.
Clinical goal: Achievement of complete remission — tyrosine-kinase inhibitors reach this endpoint in the great majority of patients with Ph+ ALL.
DOI: 10.1182/blood.2023023568