Pre‐and post‐HSCT use of TKI therapy for fusion‐driven B‐ALL: A case series of five pediatric, adolescent and young adult patients

Abstract

Abstract Background The development of tyrosine kinase inhibitors (TKIs) has significantly improved survival rates among patients with Philadelphia chromosome (Ph+) B cell acute lymphoblastic leukemia (B‐ALL). Ph‐like B‐ALL patients lack the BCR::ABL1 translocation but share gene expression profiles with Ph+ B‐ALL. The role of TKIs for Ph‐like patients pre‐ and post‐hematopoietic stem cell transplantation (HSCT) is not yet clear. Case Here we present five cases of pediatric, adolescent, and young adult patients who presented with Ph‐like B‐ALL or CML in B‐ALL blast phase who were treated with personalized TKI regimens pre‐ and post‐HSCT. Conclusion This report describes several novel Ph‐like fusions as well as combinations of TKIs with chemotherapy or immunotherapy not yet reported in the pediatric population. This case series provides real‐world experience highlighting the potential application of pre‐ and post‐HSCT use of TKIs in a subset of patients with targetable fusions.

Keywords

• acute lymphocytic leukemia
• chronic myeloid leukemia
• hematopoietic stem cell transplant
• tyrosine kinase inhibitor