Das ist eben nicht mehr der Fall!
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4349266/
Dank der TKI ist die Prognose erheblich verbessert worden:Ph-positive (Ph+) ALL patients often present with an aggressive leukemia that is resistant to standard therapies resulting in high relapse rates. In the era of pre-tyrosine kinase inhibitors (TKIs), Ph+ ALL patients who were treated with conventional chemotherapy showed a long-term survival rate of only 10%.3–6 Upon standard chemotherapy, disease-free survival (DFS) was found to be 25%–30% in children7 and less than 20% in adults.3–6
The prognosis of Ph+ ALL patients has dramatically improved upon the approval of a 1st-generation BCR–ABL tyrosine kinase inhibitor (TKI), imatinib mesylate, as first-line treatment. Although TKI monotherapy may lead to CR rates of 90%–100% with a remarkable low toxicity profile even in older patients,11–12 combining TKI treatment with standard chemotherapy has led to an overall higher long-term DFS in both adults6,13–22 and children.23,24 The use of TKIs as front-line therapy of Ph+ ALL has led to improved outcome not only because of a higher number of patients achieving CR, but also due to a lower early death rate and decreased disease recurrence. As a result, an increasingly higher number of Ph+ ALL patients are now becoming eligible for SCT. In this regard, imatinib-based induction and consolidation regimens followed by matched related or unrelated allogeneic SCT (allo-SCT) in CR1 (whenever possible according to patient age and drug intolerance) have been shown to be highly effective against Ph+ ALL.25The authors concluded that early post-transplant imatinib can effectively prevent molecular occurrence and, as a consequence, subsequent hematologic relapse, resulting in excellent remission duration (83% at 5 years) and survival (77% at 5 years).März 2015 publiziert, also mMn definitiv relevant für unser Examen.In conclusion, the use of TKIs has significantly improved the outcome of Ph+ ALL undergoing SCT. Thus, it is likely that this scenario will be further improved by the use of other innovative biological drugs such as the T-cell engaging bispecific antibody blinatumomab. This molecule has been shown to be highly effective in inducing durable remission in refractory/resistant Ph+ ALL in both adults41 and children.42