Dasatinib as first-line therapy for Philadelphia chromosome-positive acute lymphoblastic leukemia: four cases report and literature review

Objective To study the clinical effect of second-generation tyrosine kinase inhibitor dasatinib as first-line therapy for Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ALL).Methods Dasatinib was used as the first-line therapy for four Ph+ALL patients,and related literatures were reviewed.Results Four cases treated by dasatinib as the first-line therapy achieved significant curative effects without increasing any treatment-related side effects.In all of the four cases,hematological complete remission was achieved after 4-6 weeks,and complete molecular response or major molecular response was achieved after 10-12 weeks after therapy.The progress-free survival of the four cases was 10.5,24.0,8.5 and 10.0 months,respectively.Conclusion Dasatinib leads to significant curative effects in Ph+ALL and is well tolerated.Therefor,it is recommended to consider dasatinib as the first-line therapy. Key words: Leukemia, lymphoblastic, acute;  Dasatinib;  Philadelphia chromosome;  First-line therapy