About one in five adults with ALL and a small number of children with ALL have Ph-positive ALL. Patients with Ph-positive ALL have a translocation of chromosomes 22 and 9. This abnormal structure results in a gene mutation (change) called BCR-ABL.
To treat the Philadelphia-positive (Ph-positive) subtype of acute lymphoblastic leukemia (ALL), doctors usually combine multidrug chemotherapy with another drug therapy. During induction therapy, along with chemotherapy, you will be treated with a class of drugs called tyrosine kinase inhibitors (TKIs). TKIs block the leukemia-causing effects of BCR-ABL and are combined with other chemotherapy drugs. TKIs are oral medications (pills you swallow). TKIs approved by the Food and Drug Administration are:
- Imatinib mesylate (Gleevec®)
- Dasatinib (Sprycel®)
- Ponatinib (Iclusig®)
Gleevec with chemotherapy works effectively for some Ph-positive patients. Sprycel is the standard treatment for patients who respond poorly to Gleevec and Iculsig is another option.
During post-remission therapy, you will take Gleevec (or another related drug) with other drugs. Most people with Ph-positive ALL stay on Gleevec or a similar drug after consolidation therapy is finished.