Ph-Positive ALL Therapy
To treat the Philadelphia-positive (Ph-positive) subtype of acute lymphoblastic leukemia (ALL), doctors usually combine multidrug chemotherapy with another drug therapy. About one in five adults with ALL and a small number of children with ALL have Ph-positive ALL.
Patients with Ph-positive ALL have a translocation of chromosomes 22 and 9. This abnormal structure results in a gene mutation (change) called BCR-ABL.
During induction therapy, you may be treated with a class of drugs called tyrosine kinase inhibitors (TKIs). TKIs block the leukemia-causing effects of BCR-ABL and are combined with other chemotherapy drugs. TKIs are oral medications (drugs you swallow). TKIs approved by the Food and Drug Administration are:
- imatinib mesylate (Gleevec®)
- dasatinib (Sprycel®)
- Ponatinib (Iclusig®) is FDA approved for patients with chronic, accelerated, and blast phase Philadelphia chromosome-positive ALL who are resistant or intolerant to other tyrosine kinase inhibitors (TKIs). The safety and effectiveness of Iclusig were evaluated in a single clinical trial of 449 patients with various phases of Ph+ ALL. All participants were treated with Iclusig.
Gleevec with chemotherapy works effectively for some Ph-positive patients. Sprycel is the standard treatment for patients who respond poorly to Gleevec.
During postremission therapy, you're given Gleevec (or another related drug) with other drugs. Most people with Ph-positive ALL stay on Gleevec or a similar drug after consolidation therapy is finished.
If you would like to read about these drugs individually, including information about side effects, click here.