Gleevec is a kinase inhibitor indicated for the treatment of:...Adult patients with relapsed or refractory Philadelphia chromosome positive acute lymphoblastic leukemia (Ph+ ALL)...Pediatric patients with newly diagnosed Philadelphia chromosome positive acute lymphoblastic leukemia (Ph+ ALL) in combination with chemotherapy

Ph+ acute lymphoblastic leukaemia (ALL), a type of cancer in which lymphocytes (another type of white blood cell) multiply too quickly. Glivec is used in combination with other anticancer medicines in adults and children who have been newly diagnosed with Ph+ ALL. It is also used alone to treat adults with Ph+ ALL that has returned following previous treatment, or is not responding to other medicines....

INDUCTION REGIMENS FOR Ph-POSITIVE ALL: Other Recommended regimens…TKI + vincristine + dexamethasone…TKI options include (in alphabetical order): bosutinib, dasatinib, imanitib, nilotinib or ponatinib.

Table 4. Recommendations for TKI/chemotherapy combinations in adults with Ph+ ALL…Adults with Ph+ ALL should be treated front line with a combination of imatinib or second-generation TKI and chemotherapy.

...- Patients must have histologically confirmed BCR-ABL1 associated (Ph+) acute lymphoblastic leukemia (ALL) with primary refractory or relapsed disease; demonstration of BCR-ABL1 in leukemia cells by one or more of the following is required: t(9;22)(q34;q11.2) cytogenetics; FISH for BCR-ABL1 fusion; RT-PCR for BCR-ABL1 fusion...

...a clinical trial in 56 patients with relapsed or refractory Ph+ acute lymphoblastic leukemia (ALL; 48 patients) or chronic myelogenous leukemia in lymphoid blast crisis (LyBC; 8 patients). Imatinib was given once daily at 400 mg or 600 mg. Imatinib induced complete hematologic responses (CHRs) and complete marrow responses (marrow-CRs) in 29% of ALL patients (CHR, 19%; marrow-CR, 10%)...

Patients with Ph + ALL that received allo HCT were enrolled in the study…A total of 82 patients were enrolled. Sixty-two patients initiated imatinib therapy post-HCT...(qRT-PCR) was used to detect BCR-ABL transcript levels...Among the patients in imatinib and non-imatinib groups, the estimated 5-year relapse rate was 10.2% and 33.1% (p = 0.016), and the 5-year probability of DFS was 81.5% and 33.5% (p = 0.000) with the median follow-up of 31 months (range, 2.5-76 months) and 24.5 months (range, 4-72 months), respectively...These results indicate that relapse rate can be reduced and DFS may be improved in Ph + ALL patients with imatinib maintenance therapy after HCT. BCR-ABL monitoring by qRT-PCR can guide maintenance therapy with imatinib including initiation time and treatment duration after allo-HCT.