The Role of Allogeneic Hematopoietic Cell Transplantation in the Management of Philadelphia Chromosome-Positive Acute Lymphoblastic Leukemia in the Era of Tyrosine Kinase Inhibitors - PubMed
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- Introduction of tyrosine kinase inhibitors (TKIs) and immunotherapy like blinatumomab has transformed frontline therapy for Ph+ ALL.
- Allogeneic hematopoietic cell transplantation (HCT) is no longer considered indispensable for all patients; its role is now individualized based on factors like MRD and TKI response.
- Patients achieving deep MRD negativity with TKIs and immunotherapy may have durable remissions without transplant, though long-term data are limited.
- For those undergoing allogeneic HCT, optimizing transplant strategy, including donor selection and post-transplant TKI maintenance, is crucial to maximize benefits and reduce toxicity.
- Emerging approaches include treatment-free remission after TKI maintenance and CAR T-cell therapy as a bridge, consolidation, or salvage.