What are the treatment recommendations for Philadelphia chromosome–positive acute lymphoblastic leukemia (ALL) in adults 40 years or older?

Updated: Oct 23, 2019
  • Author: Karen Seiter, MD; Chief Editor: Koyamangalath Krishnan, MD, FRCP, FACP  more...
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Answer

Answer

Philadelphia chromosome–positive ALL in the older adult (age ≥40 y):

  • Chemotherapy (eg, hyper-CVAD) plus TKI; consider allogeneic stem cell transplantation if an appropriate donor is available and the patient has a good performance status and no or limited comorbidities; if transplantation is not feasible, continue multiagent chemotherapy and a TKI

  • Consider TKI plus corticosteroids in patient ≥ 65 y (evaluate end-organ reserve, end-organ dysfunction, and performance status) or with substantial comorbidities


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