{"entity":{"id":"ph-like-all","kind":"term","name":"Ph-like (BCR::ABL1-like) acute lymphoblastic leukaemia","aka":["Ph-like","Ph-like ALL","BCR::ABL1-like ALL","BCR-ABL1-like","Philadelphia chromosome-like ALL","Ph-like signature","Ph-like gene expression signature","CRLF2 rearrangement","CRLF2-rearranged","CRLF2 overexpression","ABL-class fusion","ABL-class fusions","JAK-STAT class ALL","EPOR rearrangement"],"tldr":"Ph-like leukaemia has the gene-expression fingerprint of Philadelphia-positive leukaemia without the Philadelphia chromosome; behind it are dozens of kinase fusions and JAK pathway lesions, and finding which one is present tells doctors whether an imatinib-type drug or a JAK inhibitor might be added to chemotherapy.","summary":"What is measured: a gene expression signature resembling BCR::ABL1-positive ALL, and then the lesion driving it. How: the signature by low-density array, RNA sequencing or a targeted classifier; the driver by flow cytometry for CRLF2 overexpression and FISH for CRLF2 rearrangement (IGH::CRLF2 or P2RY8::CRLF2, about half of cases, usually with JAK2 or JAK1 mutations), FISH or RNA sequencing for ABL-class fusions (ABL1, ABL2, PDGFRB, CSF1R), JAK2 and EPOR rearrangements, and sequencing for JAK1, JAK2, IL7R and SH2B3 mutations; IKZF1 deletion is common. It accounts for 10 to 15 percent of childhood, 25 to 30 percent of adolescent and young adult and about 20 percent of adult B-ALL, more often in people of Hispanic ancestry, with high residual disease after induction and poor survival on chemotherapy alone. What a positive result changes: ABL-class fusions get dasatinib or imatinib added, as for Ph-positive disease; JAK-STAT lesions are treated with ruxolitinib in trials (COG AALL1521); everyone is treated on high-risk arms with residual disease measured closely, and blinatumomab, inotuzumab or CAR-T are used for persistent disease with transplant considered in first remission. Where it matters: the Ph-like ALL page, adult ALL and high-risk childhood ALL.","asOf":"2026-09-17","links":[],"tags":[],"related":["philadelphia-chromosome","b-all-cytogenetic-risk","dasatinib","imatinib","ruxolitinib","rna-seq","fish","flow-cytometry","mrd","blinatumomab"],"cancers":["all-ph-like","all-leukemia","all-paediatric-high-risk"],"sections":[],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"category":"Biomarkers"},"route":"/terms/ph-like-all/","neighbours":{"term":[{"id":"b-all-cytogenetic-risk","kind":"term","name":"B-ALL risk groups (NCI criteria, ETV6::RUNX1, hyperdiploidy, hypodiploidy, iAMP21, IKZF1, CNS status)","route":"/terms/b-all-cytogenetic-risk/"},{"id":"fish","kind":"term","name":"FISH / ISH (in situ hybridisation)","route":"/terms/fish/"},{"id":"flow-cytometry","kind":"term","name":"Flow cytometry (immunophenotyping)","route":"/terms/flow-cytometry/"},{"id":"mrd","kind":"term","name":"Minimal / molecular residual disease (MRD)","route":"/terms/mrd/"},{"id":"philadelphia-chromosome","kind":"term","name":"Philadelphia chromosome (Ph+, BCR::ABL1)","route":"/terms/philadelphia-chromosome/"}],"drug":[{"id":"blinatumomab","kind":"drug","name":"Blinatumomab","route":"/drugs/blinatumomab/"},{"id":"dasatinib","kind":"drug","name":"Dasatinib","route":"/drugs/dasatinib/"},{"id":"imatinib","kind":"drug","name":"Imatinib","route":"/drugs/imatinib/"},{"id":"ruxolitinib","kind":"drug","name":"Ruxolitinib","route":"/drugs/ruxolitinib/"}],"technology":[{"id":"rna-seq","kind":"technology","name":"RNA sequencing & expression profiling","route":"/technologies/rna-seq/"}],"cancer":[{"id":"all-leukemia","kind":"cancer","name":"Acute lymphoblastic leukaemia","route":"/cancers/all-leukemia/"},{"id":"all-paediatric-high-risk","kind":"cancer","name":"High-risk acute lymphoblastic leukaemia in children (high-risk B-ALL and T-ALL)","route":"/cancers/all-paediatric-high-risk/"},{"id":"all-ph-like","kind":"cancer","name":"Philadelphia chromosome-like acute lymphoblastic leukaemia (Ph-like or BCR::ABL1-like ALL)","route":"/cancers/all-ph-like/"}]}}