Moving Toward a Chemotherapy-Free Approach for Philadelphia-Chromosome-Positive Acute Lymphoblastic Leukemia

Philadelphia-chromosome-positive (Ph +) acute lymphoblastic leukemia (ALL) is a genetically distinct subtype of ALL that is common in adults and is associated with poor prognosis. Historically, survival rates with intensive chemotherapy were poor, but improved with the routine incorporation of tyrosine kinase inhibitors (TKIs) into treatment. Recently, the use of novel agents, such as blinatumomab, and use of second- and third-generation TKIs has improved outcomes even further and may eventually eliminate the need for cytotoxic chemotherapy in this patient population. This review focuses on the newer “chemotherapy-free” approaches to Ph + ALL and discusses the still unanswered questions.