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.
To treat the Philadelphia-positive (Ph-positive) subtype of acute lymphoblastic leukemia (ALL), doctors usually combine multidrug chemotherapy with another drug therapy. During induction therapy, along with chemotherapy, you will 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 (pills you swallow). TKIs approved by the Food and Drug Administration are:
- Imatinib mesylate (Gleevec®)
- Dasatinib (Sprycel®)
- Ponatinib (Iclusig®)
Gleevec with chemotherapy works effectively for some Ph-positive patients. Sprycel is the standard treatment for patients who respond poorly to Gleevec and Iclusig is another option.
During postremission therapy, you will take 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.