Advances and potential treatment for Philadelphia chromosome-positive adult acute lymphoid leukaemia.

Philadelphia chromosome-positive (Ph+) acute lymphoblastic leukaemia (ALL) is the most common subtype of ALL in adults. Conventional chemotherapy-based approaches that are effective in other precursor B cell ALL cases have a poor chances of cure in patients with a Ph+ diagnosis. Therefore, allogeneic stem cell transplantation performed during the first remission is the recommended therapy. Recently, the availability of imatinib mesylate and other tyrosine kinase inhibitors and small molecules that affect the BCR/ABL signalling pathways has introduced a new therapeutic opportunity, and could change the treatment paradigm and prognosis for these patients. In this article, the results from clinical trials using imatinib in relapsed/refractory patients and as front-line therapy are described. In addition, preliminary experiences with novel tyrosine kinase inhibitors in imatinib-resistant Ph+ ALL are discussed.