Philadelphia-positive acute lymphoblastic leukemia: current treatment options

Curr Oncol Rep. 2012 Oct;14(5):387-94. doi: 10.1007/s11912-012-0247-7.

Abstract

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.

Publication types

  • Review

MeSH terms

  • Aniline Compounds / therapeutic use
  • Antineoplastic Agents / therapeutic use*
  • Benzamides
  • Dasatinib
  • Humans
  • Imatinib Mesylate
  • Imidazoles / therapeutic use
  • Neoplasm, Residual / diagnosis
  • Nitriles / therapeutic use
  • 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
  • Stem Cell Transplantation
  • Thiazoles / therapeutic use

Substances

  • Aniline Compounds
  • Antineoplastic Agents
  • Benzamides
  • DCC-2036
  • Imidazoles
  • Nitriles
  • Piperazines
  • Protein Kinase Inhibitors
  • Pyridazines
  • Pyrimidines
  • Quinolines
  • Thiazoles
  • ponatinib
  • bosutinib
  • Imatinib Mesylate
  • Dasatinib