Do Philadelphia chromosome-positive ALL patients need a stem cell transplant?

Susan O'Brien, MD from the University of California, Irvine, CA discusses Philadelphia chromosome-positive (Ph+) acute lymphoblastic leukemia (ALL) and the question of stem cell transplantation at the American Society of Oncology (ASCO) 2016 Annual Meeting held in Chicago, IL. Historically, Ph+ ALL was considered one of the most high-risk ALLs as the disease always recurred. Allogeneic stem cell transplant was seen as the only possible cure, however, this was limited by factors such as age. Dr O'Brien explains how the outcome for Ph+ ALL and chronic myeloid leukemia (CML) patients was changed with the use of tyrosine kinase inhibitors (TKI) targeting the Philadelphia chromosome. The first commercially available TKI was imatinib followed by dasatinib. Dr O'Brien explains that these drugs have revolutionized the outcomes of these diseases; patients can achieve remission and it is also possible to get them into a minimal residual disease (MRD) state. In this context, Dr O'Brien discusses whether patients need to have stem cell transplants and an upcoming trial on the question.