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Current Treatment Options in Oncology

Erschienen in:

01.01.2019 | Leukemia (PH Wiernik, Section Editor)

Treatment of Philadelphia Chromosome-Positive Acute Lymphoblastic Leukemia

verfasst von: Iman Abou Dalle, MD, Elias Jabbour, MD, Nicholas J. Short, MD, Farhad Ravandi, MD

Erschienen in: Current Treatment Options in Oncology | Ausgabe 1/2019

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Opinion statement

With the introduction of tyrosine kinase inhibitors (TKIs) in the management of Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ ALL), the prognosis of patients has improved dramatically. Currently, the standard of care in the frontline setting for fit patients is TKI in combination with chemotherapy. Age-adjusted chemotherapy or corticosteroids alone have been used with TKIs in elderly patients with comorbidities with modest long-term benefit. The primary goal of treatment is the achievement of early deep molecular remission as the achievement of complete molecular remission (CMR) at 3 months has been demonstrated to be predictive of higher long-term survival. The probability of attaining this goal by a more potent TKIs like dasatinib or ponatinib is higher, thus we recommend the use of second- or third-generation TKIs over imatinib. Clinicians should be aware of possible fatal cardiovascular events mainly related to ponatinib. Allogeneic hematopoietic stem cell transplantation (alloHSCT) should still be considered in first remission, especially for younger patients treated with imatinib combination therapy. A subset of patients achieving CMR at 3 months may be able to continue consolidation and maintenance with chemotherapy and TKI without the need for alloHSCT. Because of higher risk of relapses in the central nervous system, intrathecal chemoprophylaxis is mandatory for all patients. New strategies incorporating novel agents, such as antibody-drug conjugates, bispecific monoclonal antibodies, potent TKIs, and CAR T cells are under investigation.

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Titel: Treatment of Philadelphia Chromosome-Positive Acute Lymphoblastic Leukemia
verfasst von: Iman Abou Dalle, MD
Elias Jabbour, MD
Nicholas J. Short, MD
Farhad Ravandi, MD
Publikationsdatum: 01.01.2019
Verlag: Springer US
Erschienen in: Current Treatment Options in Oncology / Ausgabe 1/2019
Print ISSN: 1527-2729
Elektronische ISSN: 1534-6277
DOI: https://doi.org/10.1007/s11864-019-0603-z

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18.04.2024 | Wirbelsäulenmetastase | Nachrichten

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Treatment of Philadelphia Chromosome-Positive Acute Lymphoblastic Leukemia

Opinion statement

Neu im Fachgebiet Onkologie

Stereotaktische Radiatio schlägt konventionelle Bestrahlung

Adjuvante Brustkrebstherapie: Doppelt hält besser

Manche Gestagene können das Risiko für Meningeome erhöhen

Einladung zum PSA-Screening senkt die Krebssterblichkeit

Update Onkologie

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Opinion statement

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