The clonal evolution of two distinct T315I-positive BCR-ABL1 subclones in a Philadelphia-positive acute lymphoblastic leukemia failing multiple lines of therapy: a case report

open10noThis study was supported by FP7 NGS-PTL agreement n° 306.242 and Progetto Regione-Università 2010–12 (L. Bolondi) grants to GM. The funding body had no role in the design of the study and collection, analysis, and interpretation of data and in writing of this manuscriptThe treatment of Philadelphia chromosome-positive Acute Lymphoblastic Leukemia (Ph+ ALL) patients who harbor the T315I BCR-ABL1 mutation or who have two or more mutations in the same BCR-ABL1 molecule is particularly challenging since first and second-generation Tyrosine Kinase Inhibitors (TKIs) are ineffective. Ponatinib, blinatumomab, chemotherapy and transplant are the currently available options in these cases.openDe Benedittis, Caterina; Papayannidis, Cristina; Venturi, Claudia; Maria Chiara, Abbenante; Paolini, Stefania; Parisi, Sarah; Sartor, Chiara; Cavo, Michele; Martinelli, Giovanni; Soverini, SimonaDe Benedittis, Caterina; Papayannidis, Cristina; Venturi, Claudia; Maria Chiara, Abbenante; Paolini, Stefania; Parisi, Sarah; Sartor, Chiara; Cavo, Michele; Martinelli, Giovanni; Soverini, Simon