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Javier Pinilla-Ibarz and Alfonso Quintás-Cardama

+) chromosome-positive leukemias who are resistant or intolerant to imatinib and second generation tyrosine kinase inhibitors [abstract] . Blood 2007 ; 110 : Abstract 469 . 62 Pinilla-Ibarz J Kantarjian HM Cortes JE . A phase I study of INNO-406

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Susan O'Brien, Ellin Berman, Joseph O. Moore, Javier Pinilla-Ibarz, Jerald P. Radich, Paul J. Shami, B. Douglas Smith, David S. Snyder, Hema M. Sundar, Moshe Talpaz and Meir Wetzler

years, and eventually leads to terminal blast-phase disease, with death occurring from bleeding and infectious complications. 3 First-Line Treatment: Imatinib Versus Second-Generation Tyrosine Kinase Inhibitors Imatinib Imatinib is a selective inhibitor

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Giuseppe Saglio and Carmen Fava

Jabbour E Kantarjian H O'Brien S . Predictive factors for outcome and response in patients treated with second-generation tyrosine kinase inhibitors for chronic myeloid leukemia in chronic phase after imatinib failure . Blood 2011 ; 117 : 1822 - 1827

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Joseph C. Alvarnas, Patrick A. Brown, Patricia Aoun, Karen Kuhn Ballen, Stefan K. Barta, Uma Borate, Michael W. Boyer, Patrick W. Burke, Ryan Cassaday, Januario E. Castro, Peter F. Coccia, Steven E. Coutre, Lloyd E. Damon, Daniel J. DeAngelo, Dan Douer, Olga Frankfurt, John P. Greer, Robert A. Johnson, Hagop M. Kantarjian, Rebecca B. Klisovic, Gary Kupfer, Mark Litzow, Arthur Liu, Arati V. Rao, Bijal Shah, Geoffrey L. Uy, Eunice S. Wang, Andrew D. Zelenetz, Kristina Gregory and Courtney Smith

Treatment of acute lymphoblastic leukemia (ALL) continues to advance, as evidenced by the improved risk stratification of patients and development of newer treatment options. Identification of ALL subtypes based on immunophenotyping and cytogenetic and molecular markers has resulted in the inclusion of Philadelphia-like ALL and early T-cell precursor ALL as subtypes that affect prognosis. Identification of Ikaros mutations has also emerged as a prognostic factor. In addition to improved prognostication, treatment options for patients with ALL have expanded, particularly with regard to relapsed/refractory ALL. Continued development of second-generation tyrosine kinase inhibitors and the emergence of immunotherapy, including blinatumomab and chimeric antigen receptor T-cell therapy, have improved survival. Furthermore, incorporation of minimal residual disease (MRD) monitoring has shown insight into patient outcomes and may lead to treatment modification or alternative treatment strategies in select populations. This excerpt focuses on the sections of the ALL guidelines specific to clinical presentation and diagnosis, treatment of relapsed/refractory ALL, and incorporation of MRD monitoring. To view the most recent complete version of these guidelines, visit NCCN.org.

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with ovarian cancer into clinical trials must be encouraged. Second-Line TKIs Offer Expanded Treatment Options for Newly Diagnosed Patients with CML Second-generation tyrosine kinase inhibitor (TKI) therapies approved for first-line therapy of

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David D. Stenehjem, Frederick Albright, Kuan-Ling Kuo, Karina Raimundo, Hillevi Bauer, Paul J. Shami, Michael W. Deininger, Lei Chen and Diana I. Brixner

to imatinib. 5 The second-generation tyrosine kinase inhibitors (TKIs) dasatinib and nilotinib have increased potency compared with imatinib. 6 , 7 They were approved initially for patients in whom imatinib had failed, and subsequently for front

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Helena A. Yu and Gregory J. Riely

In a phase I trial that established the MTD of 50 mg daily orally, the dose-limiting toxicities were rash and Table 2 First-Line Clinical Trials of Second-Generation Tyrosine Kinase Inhibitors: Unselected Patients dyspnea secondary to

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Merav Bar and Jerald Radich

patient with disease molecular relapse and chronic GVHD after haploidentical BMT: an immunomodulatory effect? Bone Marrow Transplant 2009 ; 44 : 331 – 332 . 43. Klyuchnikov E Schafhausen P Kroger N . Second-generation tyrosine kinase

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Susan O'Brien, Camille N. Abboud, Mojtaba Akhtari, Jessica Altman, Ellin Berman, Daniel J. DeAngelo, Steven Devine, Amir T. Fathi, Jason Gotlib, Madan Jagasia, Joseph O. Moore, Javier Pinilla-Ibarz, Jerald P. Radich, Vishnu V.B. Reddy, Neil P. Shah, Paul J. Shami, B. Douglas Smith, David S. Snyder, Meir Wetzler and Furhan Yunus

Verma D Kantarjian H Shan J . Survival outcomes for clonal evolution in chronic myeloid leukemia patients on second generation tyrosine kinase inhibitor therapy . Cancer 2010 ; 116 : 2673 - 2681 . 115 Kantarjian HM Talpaz M O'Brien S

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Susan O'Brien, Ellin Berman, Hossein Borghaei, Daniel J. DeAngelo, Marcel P. Devetten, Steven Devine, Harry P. Erba, Jason Gotlib, Madan Jagasia, Joseph O. Moore, Tariq Mughal, Javier Pinilla-Ibarz, Jerald P. Radich, Neil P. Shah, Paul J. Shami, B. Douglas Smith, David S. Snyder, Martin S. Tallman, Moshe Talpaz and Meir Wetzler

. 168 Breccia M Palandri F Iori AP . Second-generation tyrosine kinase inhibitors before allogeneic stem cell transplantation in patients with chronic myeloid leukemia resistant to imatinib . Leuk Res 2009 ; in press . 169 Kolb HJ