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What maintenance treatment would you recommend for Ph positive ALL following Hyper-CVAD, transplant eligible or ineligible?

1 Answer
Mednet MemberInvited Expert
Medical Oncology · University of Washington
Answered on

While ABL kinase inhibitors (TKIs) are commonly recommended as maintenance post-transplant in Ph+ ALL, the data supporting this practice are relatively soft. Position statements from expert panels convened by EBMT (Giebel et al., PMID 27309127) and ASTCT (DeFilipp et al., PMID 31446198) both generally recommend maintenance or "prophylactic" TKI post-transplant, but also point out the "pre-emptive" treatment for MRD recurrence is also acceptable. The duration of therapy is generally 1 year of MRD-negativity. The best TKI to use is unknown. Most prospective trials have used imatinib, but dasatinib (Ravandi et al., PMID 29046900) and nilotinib (Carpenter et al., PMID 28698203) have also been studied. Personally, for patients who responded well...

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