T315I in Ph+ B-ALL — same biological consequence as in CML: pan-resistance to 1st/2nd-gen...
Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.
| ID | BMA-BCR-ABL1-T315I-BALL |
|---|---|
| Type | Actionability |
| Status | reviewed 2026-04-27 | pending_clinical_signoff | actionability review required |
| Diseases | DIS-B-ALL |
| Sources | SRC-CIVIC SRC-NCCN-BCELL-2025 SRC-PACE-CORTES-2013 |
Actionability Facts
| Biomarker | BIO-BCR-ABL1 |
|---|---|
| Variant | T315I (gatekeeper resistance) |
| Disease | DIS-B-ALL |
| ESCAT tier | IA |
| Recommended combinations | ponatinib + chemotherapy (hyper-CVAD or pediatric backbone), ponatinib + blinatumomab (chemo-free) |
| Contraindicated monotherapy | imatinib / dasatinib / nilotinib / bosutinib (resistant) |
| Evidence summary | T315I in Ph+ B-ALL — same biological consequence as in CML: pan-resistance to 1st/2nd-gen TKIs. Ponatinib + chemotherapy is standard (Jabbour 2018, hyper-CVAD + ponatinib). T315I is more common in B-ALL than CML at presentation due to faster disease tempo and higher mutation pressure under early TKI exposure. |
Notes
OncoKB R1. Allo-HCT consolidation strongly considered. Ponatinib is the only TKI with clinical activity vs T315I in B-ALL setting.
Used By
No reverse references found in the YAML corpus.