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Ph+ B-ALL (typically p190) requires TKI-incorporating regimens. Modern trials (D-ALBA, Fo...

Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.

IDBMA-BCR-ABL1-P190-BALL
TypeActionability
Statusreviewed 2026-04-27 | pending_clinical_signoff | actionability review required
DiseasesDIS-B-ALL
SourcesSRC-BLAST-GOKBUGET-2018 SRC-CIVIC SRC-NCCN-BCELL-2025

Actionability Facts

BiomarkerBIO-BCR-ABL1
Variantp190 (e1a2) — typical Ph+ B-ALL
DiseaseDIS-B-ALL
ESCAT tierIA
Recommended combinationsponatinib + hyper-CVAD (1L), dasatinib + blinatumomab (D-ALBA chemo-light), imatinib + chemotherapy (1L alternative, lower-resource setting), ponatinib + blinatumomab (chemo-free regimen)
Contraindicated monotherapyTKI alone without chemotherapy or immunotherapy backbone (insufficient durability)
Evidence summaryPh+ B-ALL (typically p190) requires TKI-incorporating regimens. Modern trials (D-ALBA, Foà 2020; GIMEMA LAL2116) show dasatinib + blinatumomab achieves molecular CR in >60% with reduced chemotherapy. Ponatinib + hyper-CVAD (Jabbour 2024) and ponatinib + blinatumomab combos extend this further. TKI selection now favors ponatinib for highest molecular-response rates.

Notes

ESCAT IA. Ponatinib preferred for highest molecular-response rates and to preempt T315I emergence. CNS prophylaxis essential. Allo-HCT consideration based on MRD response per ELN/NCCN.

Used By

No reverse references found in the YAML corpus.