Optimal management of elderly/old Ph+ acute lymphoblastic leukemia patients.

Today, Philadelphia-positive acute lymphoblastic leukemia (Ph+ ALL) is a curable disease. In real life, too many adult ALL patients are not adequately worked up at diagnosis and treated, and this occurs, in particular, in elderly/old individuals. Here, we present representative case descriptions to discuss how Ph+ ALL patients diagnosed in their seventh, eight and ninth decade of life can, through a timely, accurate and personalized administration of tyrosine kinase inhibitor (TKI), without systemic chemotherapy, experience long-lived responses, minimal residual disease negativity, and a good quality of life. In this scenario, stopping TKI administration can also be considered. This perspective article represents a proof of concept that, nowadays, even in elderly/old Ph+ ALL, the disease can be cured or kept under prolonged control if adequately managed.