Induction therapy |
A BCR-ABL tyrosine kinase inhibitor (TKI) plus one of the following combination chemotherapy regimens:
The combination of a TKI with or without a corticosteroid is capable of producing complete remissions in previously untreated Ph+ ALL with low toxicity[6]. This combination has not been directly compared with a TKI plus chemotherapy. If initial data are supported by subsequent studies, the combination of a TKI plus steroid may become an excellent option for patients, such as older adults, who are not able to tolerate combination chemotherapy. |
Consolidation |
Allogeneic hematopoietic cell transplantation in first complete remission is preferred. If the patient is not a candidate for transplantation, consolidation chemotherapy should be given that incorporates a BCR-ABL TKI. |
Maintenance |
A BCR-ABL TKI for two years after allogeneic hematopoietic cell transplantation or indefinitely if a transplantation is not performed |
Follow-up |
Serial bone marrow evaluation and minimal residual disease testing with BCR-ABL transcripts using real time quantitative polymerase chain reaction |
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