How I diagnose and manage Philadelphia chromosome-like acute lymphoblastic leukemia.

How I diagnose and manage Philadelphia chromosome-like acute lymphoblastic leukemia. Haematologica. 2019 Oct 03;: Authors: Frisch A, Ofran Y Abstract Advances in our understanding of mechanisms of leukemogenesis and driver mutations in acute lymphoblastic leukemia lead to a more precise and informative sub-classification, mainly of B-acute lymphoblastic leukemia. In parallel, in recent years, novel agents have been approved for B-acute lymphoblastic leukemia therapy, and many others are in active clinical research. Among the newly recognized disease subtypes, Philadelphia-chromosome-like acute lymphoblastic leukemia is most heterogeneous and thus, diagnostically challenging. Given that this B-acute lymphoblastic leukemia subtype is associated with a poorer prognosis, improvement of available therapeutic approaches and protocols is a burning issue. We have herein summarized in a clinically relevant manner, up-to-date information regarding diagnostic strategies developed for the identification of patients with Philadelphia-chromosome-like acute lymphoblastic leukemia. Common therapeutic dilemmas, presented as several case scenarios, are also discussed. It is currently acceptable that B-acute lymphoblastic leukemia patients, treated with an aim of cure, irrespective of their age, be evaluated for a Philadelphia-chromosome-like signature as early as possible. Following Philadelphia-chromosome-like recognition, a higher risk for resistanc...
Source: Haematologica - Category: Hematology Authors: Tags: Haematologica Source Type: research