This protocol addresses acute lymphoblastic leukemia in patients whose disease is characterised by the presence of the Philadelphia chromosome and/or the BCR::ABL1 fusion, confirmed through karyotyping and/or molecular genetic testing. This molecular finding defines a biologically distinct subset of ALL that requires a specific treatment approach.
Confirmation of Ph+ ALL relies on karyotyping and/or molecular genetics. Establishing this molecular status is essential before treatment decisions are made, as it directly shapes the therapeutic strategy used throughout the disease course.
The maintenance phase of Ph+ ALL involves a tyrosine-kinase inhibitor — either the agent used initially or an alternative, selected based on tolerability and efficacy. Importantly, discontinuation of the tyrosine-kinase inhibitor in patients who did not undergo transplant is generally not recommended. The full structured regimen — including sequencing, selection criteria, and monitoring guidance — is available via the complete protocol.
DOI: 10.1182/blood.2023023568
Confirmation of Ph+ ALL relies on karyotyping and/or molecular genetics.
Consolidation is followed by maintenance with the initial or an alternative TKI, depending on tolerability and efficacy.
Stopping the TKI in patients who did not undergo transplant is discouraged, even in patients with prolonged MRD-negativity.
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