Терапевтический архив (Jul 2018)

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

  • 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

DOI
https://doi.org/10.26442/terarkh2018907110-117
Journal volume & issue
Vol. 90, no. 7
pp. 110 – 117

Abstract

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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 Nowadays a unified therapeutic approach to all primary patients of the B-ALL is considered generally outdated.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.

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