[Current management of adult Philadelphia chromosome-positive acute lymphoblastic leukemia]

Tyrosine kinase inhibitors (TKIs) have improved the response and survival in patients with Philadelphia chromosome (Ph)-positive acute lymphoblastic leukemia (ALL) (Ph+ALL). Although the second and third generation TKIs are expected to greatly enhance treatment outcomes, no study has demonstrated the inferiority of allogeneic hematopoietic stem cell transplantation (allo-HSCT) to chemotherapy combined with TKIs in any subgroup of adults with Ph+ALL. Because the PCR-based detection of minimal residual disease (MRD) is easy and reliable, physicians can judge the level of treatment response. Recently, the molecular genetics risk factors of Ph+ALL in the TKI era have been revealed. These diagnostic advancements have enabled physiciansto precisely evaluate the disease risk before commencing initial treatment and to select the most suitable therapy via MRD monitoring during the treatment. Currently, new antibody therapies have been included as candidate therapies for Ph+ALL. This review discusses available treatments for adult patients with Ph+ALL.