Allogeneic stem cell transplantation for Philadelphia chromosome-positive acute lymphoblastic leukemia

The prognosis for adult and pediatric patients with Philadelphia chromosome-positive (Ph+) acute lymphoblastic leukemia (ALL) treated with chemotherapy alone is extremely poor. An overview of the biology and clinical features of Ph+ ALL is presented in this review. The experience with chemotherapy and autologous stem cell transplantation (SCT) is summarized. Allogeneic SCT offers a curative option for patients who have an appropriately matched donor. Variables affecting outcome after allogeneic SCT, including age, stage of disease, source of stem cells, preparatory regimen, and molecular and cytogenetic details, are analyzed. The City of Hope/Stanford University experience with fractionated total body irradiation and high-dose etoposide is described, and future directions for monitoring and treating minimal residual disease are discussed.