Management of Philadelphia chromosome positive (Ph+) acute lymphoblastic leukemia (ALL) in first complete remission in transplant-eligible patients

Ph+ ALL: Philadelphia chromosome positive acute lymphoblastic leukemia; CR: hematologic complete remission; MRD: measurable residual disease based on quantitative reverse transcriptase polymerase chain reaction; HCT: hematopoietic cell transplantation; TKI: BCR-ABL1 tyrosine kinase inhibitor; MD-MTX: high-dose methotrexate.
* MRD detected in bone marrow: <MR4.5 (BCR-ABL1 >10^–4.5).
¶ Change to an alternate TKI must consider the TKI toxicity profile and comorbid conditions.
Δ Some experts omit HCT for patients with no detectable MRD and proceed directly to maintenance therapy.