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Treatment Selection for Philadelphia Chromosome-Positive Acute Lymphoblastic Leukemia in the Era of Tyrosine Kinase Inhibitors
- Source :
- Chemotherapy. 64(2)
- Publication Year :
- 2019
-
Abstract
- With the advent of tyrosine kinase inhibitors (TKIs), the treatment of Philadelphia chromosome-positive (Ph+) acute lymphoblastic leukemia (ALL) has entered a new era. The efficacy of TKIs compared with other ALL treatment options is emphasized by a rapid increase in the number of TKI clinical trials. Subsequently, the use of traditional approaches, such as combined chemotherapy and even allogeneic hematopoietic stem cell transplantation (allo-HSCT), for the treatment of ALL is being challenged in the clinic. In light of the increased use of TKIs in the clinic, several questions have been raised. First, is it necessary to use intensive chemotherapy during the induction course of therapy to achieve a minimal residual disease (MRD)-negative status? Must a patient reach a complete molecular response/major molecular response before receiving allo-HSCT? Does MRD status affect long-term survival after allo-HSCT? Is auto-HSCT an appropriate alternative for allo-HSCT in those Ph+ ALL patients who lack suitable donors? Here, we review the recent literature in an attempt to summarize the current status of TKI usage in the clinic, including several new therapeutic approaches, provide answers for the above questions, and speculate on the future direction of TKI utilization for the treatment of Ph+ ALL patients.
- Subjects :
- 0301 basic medicine
Oncology
medicine.medical_specialty
Neoplasm, Residual
Lymphoblastic Leukemia
medicine.medical_treatment
030106 microbiology
Antineoplastic Agents
Hematopoietic stem cell transplantation
Philadelphia chromosome
03 medical and health sciences
0302 clinical medicine
hemic and lymphatic diseases
Internal medicine
Drug Discovery
Medicine
Humans
Pharmacology (medical)
Philadelphia Chromosome
Protein Kinase Inhibitors
Pharmacology
Philadelphia Chromosome Positive
business.industry
Hematopoietic Stem Cell Transplantation
Combination chemotherapy
General Medicine
Precursor Cell Lymphoblastic Leukemia-Lymphoma
medicine.disease
Prognosis
Minimal residual disease
respiratory tract diseases
Clinical trial
Infectious Diseases
030220 oncology & carcinogenesis
business
Tyrosine kinase
Subjects
Details
- ISSN :
- 14219794
- Volume :
- 64
- Issue :
- 2
- Database :
- OpenAIRE
- Journal :
- Chemotherapy
- Accession number :
- edsair.doi.dedup.....a752b8899339cc43e8dc86e39b7de8f6