Diagnostics and treatment challenges of Ph-like acute lymphoblastic leukemia: a description of 3 clinical cases

• Main Authors: K I ZARUBINA, E N PAROVICHNIKOVA, G A BASKHAEVA, A E KRASILNIKOVA, O A GAVRILINA, B V BIDERMAN, A B SUDARIKOV, S N BONDARENKO, Y O DAVYDOVA, I V GALTSEVA, A N SOKOLOV, V V TROITSKAYA, V G SAVCHENKO
• Format: Article
• Language: Russian
• Published: "Consilium Medicum" Publishing house 2018-07-01
• Series: Терапевтический архив
• Subjects: ph-like acute lymphoblastic leukemia; refractory; tyrosine kinase inhibitors; blinatumomab; all-trans-retinoic acid
• Online Access: https://ter-arkhiv.ru/0040-3660/article/viewFile/32813/pdf

B-cell acute lymphoblastic leukemia (B-ALL) is a diverse group of malignant blood disorders both with regard to the biological properties of the tumor and to therapeutic approaches. Immunophenotyping, molecular genetic techniques, whole-genome sequencing characterize B-ALL as a very diverse group for sensitivity to chemotherapy and prognosis. We present three clinical cases of patients with B-ALL and expected good response to standard therapy, in whom standard protocol treatment failured: refractoriness, persistence of minimal residual disease (MRD), and progression (MRD increase). The remission in these patients was achieved after chemotherapy change to immunological targeted therapy. Nowadays a unified therapeutic approach to all primary patients of the B-ALL is considered generally outdated. Great efforts are carrying out to develop molecular genetic classifications. The molecular dissection of subtypes of B-ALL goes on, and new protocols for selective treatment with targeting are clearly outlined for each subtype of B-ALL.