- Some patients do not respond to treatment at all, which is known as refractory ALL. When patients have a good initial response to treatment but ALL returns, this is known as relapsed ALL.
- Depending on the patient’s Philadelphia chromosome status, treatment for relapse will be different
- For Philadelphia chromosome-negative patients, monoclonal antibodies (blinatumomab), inotuzumab ozogamicin, and tisagenlecleucel will improve complete remission rates.
- For Philadelphia chromosome-positive, intensive chemotherapy and a TKI can achieve a complete remission rate of around 90%. Of the patients who relapse or are refractory, 75% have the mutation T315I. Changing the TKI to dasatinib, nilotinib or ponatinib can improve complete remission rates.
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