Ph-like-ALL is diagnosed by Fluorescence in situ hybridization (FISH) using FISH probes like ABL1, ABL2, CRLF2, EPOR1, CSF1R, JAK2, PDGFRB, PDGFRA, testing for these may aid in risk stratification
It is important to check for these markers to decide whether adding tyrosine kinase inhibitors (TKIs) to current therapy will improve the survival of patients with this type of leukemia.
ABL – class fusions include ABL1, ABL2, PDGFRB, and CSF1R rearrangements can be sensitive towards ABL inhibitors such as Imatinib or Dasatinib.
In Ph-like-ALL cases harboring CRLF2 & JAK2 alterations, the utility of Janus Kinase inhibitor is being explored. NCCN recommends that pediatric and AYA patients with Ph-like-ALL with early or late first relapse, the panel recommends initial treatment with systemic therapy
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