How I treat Philadelphia chromosome–positive acute lymphoblastic leukemia

The Philadelphia chromosome is present in approximately 20% to 30% of adults with acute lymphoblastic leukemia (ALL). The poor prognosis of this relatively uncommon acute leukemia has led to the rapid adoption of treatment strategies such as unrelated donor hematopoietic stem cell transplant and tyr...

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Published inBlood Vol. 116; no. 18; pp. 3409 - 3417
Main Author Fielding, Adele K.
Format Journal Article
LanguageEnglish
Published Washington, DC Elsevier Inc 04.11.2010
Americain Society of Hematology
Subjects
Antineoplastic Agents - administration & dosage
Antineoplastic Agents - therapeutic use
Antineoplastic Combined Chemotherapy Protocols
Benzamides
Biological and medical sciences
Central Nervous System Neoplasms - prevention & control
Clinical Trials as Topic
Dasatinib
Drug Resistance, Neoplasm
Fusion Proteins, bcr-abl - genetics
Hematologic and hematopoietic diseases
Hematopoietic Stem Cell Transplantation
Humans
Imatinib Mesylate
Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis
Medical sciences
Mutation
Philadelphia Chromosome
Piperazines - administration & dosage
Piperazines - therapeutic use
Precursor Cell Lymphoblastic Leukemia-Lymphoma - diagnosis
Precursor Cell Lymphoblastic Leukemia-Lymphoma - drug therapy
Precursor Cell Lymphoblastic Leukemia-Lymphoma - genetics
Precursor Cell Lymphoblastic Leukemia-Lymphoma - therapy
Prognosis
Protein Kinase Inhibitors - administration & dosage
Protein Kinase Inhibitors - therapeutic use
Pyrimidines - administration & dosage
Pyrimidines - therapeutic use
Remission Induction - methods
Thiazoles - administration & dosage
Thiazoles - therapeutic use
Philadelphia positive acute lymphoblastic leukemia
Malignant hemopathy
Treatment
Hematology
Lymphoproliferative syndrome
Cancer
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Abstract The Philadelphia chromosome is present in approximately 20% to 30% of adults with acute lymphoblastic leukemia (ALL). The poor prognosis of this relatively uncommon acute leukemia has led to the rapid adoption of treatment strategies such as unrelated donor hematopoietic stem cell transplant and tyrosine kinase inhibitors into clinical practice, despite a relative paucity of randomized clinical trials. Recently, there has been a surge of interest in the underlying biology of ALL. In combination with an accumulation of more mature clinical study data in Philadelphia-positive ALL, it is increasingly possible to make more rational and informed treatment choices for patients of all ages. In this article, I review available data and indicate how I personally interpret current evidence to make pragmatic treatment choices with my patients, outside of clinical trials. My strongest recommendation is that all physicians who are treating this rare disease actively seek appropriate clinical trials for their patients wherever possible.
AbstractList The Philadelphia chromosome is present in approximately 20% to 30% of adults with acute lymphoblastic leukemia (ALL). The poor prognosis of this relatively uncommon acute leukemia has led to the rapid adoption of treatment strategies such as unrelated donor hematopoietic stem cell transplant and tyrosine kinase inhibitors into clinical practice, despite a relative paucity of randomized clinical trials. Recently, there has been a surge of interest in the underlying biology of ALL. In combination with an accumulation of more mature clinical study data in Philadelphia-positive ALL, it is increasingly possible to make more rational and informed treatment choices for patients of all ages. In this article, I review available data and indicate how I personally interpret current evidence to make pragmatic treatment choices with my patients, outside of clinical trials. My strongest recommendation is that all physicians who are treating this rare disease actively seek appropriate clinical trials for their patients wherever possible.
Abstract The Philadelphia chromosome is present in approximately 20% to 30% of adults with acute lymphoblastic leukemia (ALL). The poor prognosis of this relatively uncommon acute leukemia has led to the rapid adoption of treatment strategies such as unrelated donor hematopoietic stem cell transplant and tyrosine kinase inhibitors into clinical practice, despite a relative paucity of randomized clinical trials. Recently, there has been a surge of interest in the underlying biology of ALL. In combination with an accumulation of more mature clinical study data in Philadelphia-positive ALL, it is increasingly possible to make more rational and informed treatment choices for patients of all ages. In this article, I review available data and indicate how I personally interpret current evidence to make pragmatic treatment choices with my patients, outside of clinical trials. My strongest recommendation is that all physicians who are treating this rare disease actively seek appropriate clinical trials for their patients wherever possible.
Author Fielding, Adele K.
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Issue 18
Keywords Philadelphia positive acute lymphoblastic leukemia
Malignant hemopathy
Treatment
Hematology
Lymphoproliferative syndrome
Cancer
Language English
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SSID ssj0014325
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Snippet The Philadelphia chromosome is present in approximately 20% to 30% of adults with acute lymphoblastic leukemia (ALL). The poor prognosis of this relatively...
Abstract The Philadelphia chromosome is present in approximately 20% to 30% of adults with acute lymphoblastic leukemia (ALL). The poor prognosis of this...
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StartPage 3409
SubjectTerms Antineoplastic Agents - administration & dosage
Antineoplastic Agents - therapeutic use
Antineoplastic Combined Chemotherapy Protocols
Benzamides
Biological and medical sciences
Central Nervous System Neoplasms - prevention & control
Clinical Trials as Topic
Dasatinib
Drug Resistance, Neoplasm
Fusion Proteins, bcr-abl - genetics
Hematologic and hematopoietic diseases
Hematopoietic Stem Cell Transplantation
Humans
Imatinib Mesylate
Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis
Medical sciences
Mutation
Philadelphia Chromosome
Piperazines - administration & dosage
Piperazines - therapeutic use
Precursor Cell Lymphoblastic Leukemia-Lymphoma - diagnosis
Precursor Cell Lymphoblastic Leukemia-Lymphoma - drug therapy
Precursor Cell Lymphoblastic Leukemia-Lymphoma - genetics
Precursor Cell Lymphoblastic Leukemia-Lymphoma - therapy
Prognosis
Protein Kinase Inhibitors - administration & dosage
Protein Kinase Inhibitors - therapeutic use
Pyrimidines - administration & dosage
Pyrimidines - therapeutic use
Remission Induction - methods
Thiazoles - administration & dosage
Thiazoles - therapeutic use
Title How I treat Philadelphia chromosome–positive acute lymphoblastic leukemia
URI https://dx.doi.org/10.1182/blood-2010-01-242750
https://www.ncbi.nlm.nih.gov/pubmed/20656928
https://search.proquest.com/docview/762684773
https://search.proquest.com/docview/847437333
Volume 116
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