Adult Philadelphia-Positive Acute Lymphoblastic Leukemia: A Single-Institution Experience in Limited-Resource Setting

Area of Science:

• Hematology
• Oncology

Background:

• Adult Philadelphia-positive (Ph+) acute lymphoblastic leukemia (ALL) is characterized by a poor prognosis.
• Tyrosine kinase inhibitors (TKIs) have improved responses but outcomes remain suboptimal.
• Allogeneic stem cell transplantation (ASCT) is often unavailable in limited-resource settings.

Purpose of the Study:

• To evaluate treatment outcomes for adult Ph+ ALL patients in limited-resource settings.
• To assess the impact of TKIs in the absence of ASCT.
• To analyze clinical characteristics and survival rates.

Main Methods:

• Retrospective analysis of case records of 18 adult Ph+ ALL patients.
• Evaluation of clinical presentation, laboratory findings, cytogenetics, and molecular data.
• Assessment of treatment protocols including BFM95 and imatinib, and survival data.

Main Results:

• Median age was 28 years; common symptoms included fever, fatigue, and splenomegaly (100% by ultrasound).
• Cytogenetic analysis confirmed the Philadelphia chromosome (t(9;22)) in 55.55% of patients.
• Median overall survival was 7.5 months, with a 2-year OS of 33.33% despite TKI treatment.

Conclusions:

• Adult Ph+ ALL carries a poor prognosis, particularly when ASCT is not feasible.
• Limited-resource settings face significant challenges in managing this disease.
• Further strategies are needed to improve survival rates for Ph+ ALL patients.