Dr. Tasian on the Heterogeneity of Ph-Like ALL in Pediatric Patients

Sarah K. Tasian, MD, an attending physician and assistant professor of pediatrics in the Division of Oncology at Children’s Hospital of Philadelphia, discusses the heterogeneity of pediatric Philadelphia (Ph)-like acute lymphoblastic leukemia (ALL).

Tasian says that what is most striking about that subset of patients with ALL is how heterogeneous the disease is. Ph-like and Ph-positive ALL have similar kinase activated gene expression profiles, but different underlying genetic lesions, and new fusions are constantly being discovered. Moving forward, Tasian believes that the best way to find treatments for this disease is through timely diagnostic interventions and subsequent enrollment on clinical trials.

Patients with Ph-like ALL are generally subtyped by 2 pathways—either the ABL-class or CRLF2/JAK pathway. Tasian says that she hopes that they can be targeted similarly, but it remains an active area of clinical investigation. She is hopeful that it will be able to be answered through trials. There is currently no frontline standard of care for patients with this subtype of ALL.