How has TKI addition changed Ph+ ALL prognosis?

Ph+ ALL was historically the highest-risk subset with CR rate of 60% and OS below 20% with chemotherapy alone. Addition of imatinib or dasatinib to induction achieves CR rates of 90–95% and 3-year OS above 50–60%. AlloSCT in first CR remains standard for eligible patients.

What defines Ph-like ALL and why is it important?

Ph-like ALL has a gene expression profile resembling Ph+ ALL but lacks BCR-ABL1. It harbors various kinase-activating alterations (JAK2 rearrangements, ABL1/ABL2 fusions, CRLF2 alterations). ABL-class fusions respond to dasatinib; JAK alterations may respond to ruxolitinib. Ph-like ALL has inferior outcomes with standard chemotherapy.

ALL Philadelphia Chromosome Prognosis

Assess the prognostic impact of Philadelphia chromosome (BCR-ABL1) positivity in acute lymphoblastic leukemia and the treatment implications of TKI addition to chemotherapy.

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Frequently Asked Questions

How has TKI addition changed Ph+ ALL prognosis?

What defines Ph-like ALL and why is it important?