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52

NCCN Guidelines for Patients

®

:

Acute Lymphoblastic Leukemia, Version 1.2017

5

Treatment guide

Older adults with Ph-positive ALL

Guide 9. Postremission consolidation and maintenance

Health status Consolidation therapy options Maintenance therapy options

Patients <65 years

of age without

serious health

problems

ª

• Allogeneic SCT if a

donor is available

or

• If allogeneic SCT donor

is not available, continue

multiagent chemotherapy

regimen + TKI

ª

• Consider post-SCT TKI

ª

• TKI, and

• Maintenance therapy with:

• Monthly vincristine/

prednisone pulses

• Weekly methotrexate

• Daily 6-MP

Patients ≥65 years

of age or with

other serious

health problems

ª

• Continue TKI ±

corticosteroids

• Continue TKI ±

chemotherapy

ª

• TKI, and

• Maintenance therapy with:

• Monthly vincristine/

prednisone pulses

• Weekly methotrexate

• Daily 6-MP

Guide 9

shows the treatment options for older

adults with Ph-positive ALL after induction therapy

resulted in a complete remission. Consolidation—

also called intensification—is the second phase of

treatment for ALL. This may also be referred to as

postremission therapy since it is given after ALL is in

complete remission. The goal of consolidation is to

kill any leukemia cells that may still be in your body.

Consolidation therapy

Your doctor will look at many factors to help plan

consolidation therapy. This includes the ALL cell

subtype, chromosome changes, results of MRD

testing, and other prognostic factors. Your general

health, current symptoms, and side effects will

also be noted. This can help to decide if you need

and can tolerate more intensive treatment for

consolidation.

If you are younger than age 65, or you don’t have

other serious health problems, there are two main

options to choose from. The first option is to have

an allogeneic SCT. This option is recommended if a

well-matched donor has been found. Consolidation

with an allogeneic SCT may help keep ALL from

coming back after a complete remission. But, it is

a very intensive treatment that may not be a good

choice for everyone.

Your doctor will look at a number of factors to decide

if an allogeneic SCT is a good choice for you. This

includes your age, general health, and ability to

tolerate intensive treatments.