Philadelphia chromosome-positive acute lymphoblastic leukaemia in children (Ph-positive ALL): lines of therapy
3 standard-of-care settings across 3 lines and 2 biomarker subgroups. Rows come from the cancer page's standard of care; the grid places each on its line and subgroup.
Advanced, first line
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|---|---|---|---|---|
| All comers | Newly diagnosed | Imatinib or dasatinib started in induction and continued throughout intensive BFM or EsPhALL-type chemotherapy; intrathecal therapy without cranial irradiation. | NCI PDQ: Childhood Acute Lymphoblastic Leukemia Treatment (health professional version) | 78 |
Third line and beyond
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|---|---|---|---|---|
| FRα | Relapsed or refractory | Switch kinase inhibitor by mutation (ponatinib for T315I, used off label in children), blinatumomab or CD19 CAR T-cells, inotuzumab ozogamicin, then transplant. | NCI PDQ: Childhood Acute Lymphoblastic Leukemia Treatment (health professional version) | 92 |
Other settings
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|---|---|---|---|---|
| All comers | Poor residual disease response | Blinatumomab to clear residual disease, then allogeneic transplant in first remission with a kinase inhibitor continued afterwards. | NCI PDQ: Childhood Acute Lymphoblastic Leukemia Treatment (health professional version) | 92 |
Lines and subgroups are parsed from the setting text of each standard-of-care row and can misclassify an unusual phrasing; the row’s own setting is always shown. Guideline chips reflect the NCCN category and ESMO-MCBS grade recorded on the cancer page, checked on its stated date. Not medical advice.