ESH ALL 2021 | Which TKI-chemo-HSCT cocktail for Ph+ ALL?

Yves Chalandon, MD, PhD, University of Geneva, Geneva, Switzerland, discusses the treatment strategies available to treat Philadelphia chromosome-positive (Ph+) acute lymphoblastic leukemia (ALL). For adult patients, there have been significant changes with the combination of new generation tyrosine kinase inhibitors (TKIs), like ponatinib, with chemotherapy, or with blinatumomab. However, the follow-up from studies evaluating those combinations is still short. Currently, allogeneic hematopoietic stem cell transplant (allo-HSCT) remains the standard of care for most adult patients with Ph+ ALL, with TKI maintenance after HSCT providing the best results. Prof. Chalandon explains that the GRAAPH 2021 study will help answer whether allo-HSCT is needed or not in the era of third-generation TKI and new immunotherapies. For the pediatric population, the best strategy includes a combination of chemotherapy with second-generation TKIs, such as dasatinib, while allo-HSCT may only be recommended for high-risk patients. This interview took place during the 2021 European School of Hematology (ESH) 2nd Translational Research Conference on Acute Lymphoblastic Leukemia.