Philadelphia-positive acute lymphoblastic leukemia: current treatment options.
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.
The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Blvd., Unit 428, Houston, TX, 77007, USA.
Theresa
T
Liu-Dumlao
Hagop
H
Kantarjian
Deborah A
DA
Thomas
Susan
S
O'Brien
Farhad
F
Ravandi
D000814:Aniline Compounds / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001549:Benzamides; D000069439:Dasatinib; D006801:Humans; D000068877:Imatinib Mesylate; D007093:Imidazoles / Q000627:therapeutic use; D018365:Neoplasm, Residual / Q000175:diagnosis; D009570:Nitriles / Q000627:therapeutic use; D010879:Piperazines / Q000627:therapeutic use; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000175:diagnosis / Q000188:drug therapy* / Q000601:surgery; D047428:Protein Kinase Inhibitors / Q000627:therapeutic use*; D011724:Pyridazines / Q000627:therapeutic use; D011743:Pyrimidines / Q000627:therapeutic use; D011804:Quinolines / Q000627:therapeutic use; D033581:Stem Cell Transplantation; D013844:Thiazoles / Q000627:therapeutic use
D000814:Aniline Compounds; D000970:Antineoplastic Agents; D001549:Benzamides; C560099:DCC-2036; D007093:Imidazoles; D009570:Nitriles; D010879:Piperazines; D047428:Protein Kinase Inhibitors; D011724:Pyridazines; D011743:Pyrimidines; D011804:Quinolines; D013844:Thiazoles; C545373:ponatinib; C471992:bosutinib; D000068877:Imatinib Mesylate; D000069439:Dasatinib