TKI use in Ph+ and Ph-like ALL

Stephen Hunger, MD, The Children’s Hospital of Philadelphia, Philadelphia, PA, discusses the use of tyrosine kinase inhibitors (TKIs) in Philadelphia chromosome-positive (Ph+) and Philadelphia-like (Ph-like) acute lymphoblastic leukemia (ALL). It is now accepted that TKIs are critical in the treatment of Ph+ ALL. More recently, a high-risk subgroup of B-ALL known as Ph-like ALL was identified. Clinically, these patients are similar to Ph+ ALL; they have high white blood cell counts, poor early response, and low cure rates with standard therapy. In a subset of Ph-like ALL patients, fusions involving ABL1, ABL2, CSF1R, or PDGFRB are common and inhibited by the same ABL-class TKIs. Therefore, there is a great interest in treating patients with chemotherapy plus imatinib or dasatinib, as in Ph+ ALL, to improve outcomes. This interview took place during the 2021 European School of Hematology (ESH) 2nd Translational Research Conference on Acute Lymphoblastic Leukemia.