Treatment Selection for Philadelphia Chromosome-Positive Acute Lymphoblastic Leukemia in the Era of Tyrosine Kinase Inhibitors
| Autor: | Pei-Yan Kong, Jingkang Xiong, Cheng Zhang, Xi Zhang, Quan-Chao Zhang, Ying-Ying Ma |
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| Rok vydání: | 2019 |
| Předmět: |
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 |
| Zdroj: | Chemotherapy. 64(2) |
| ISSN: | 1421-9794 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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