Optimal management of elderly/old Ph+ acute lymphoblastic leukemia patients.

Philadelphia-positive acute lymphoblastic leukemia (Ph+ ALL) is today a curable disease. In the real life, too many adult ALL patients are not adequately worked up at diagnosis and treated, and this occurs in particular in elderly/old individuals. We hereby discuss, through representative case descriptions, how Ph+ ALL patients diagnosed in their seventh, eight and nineth decade of life through a timely, accurate and personalized tyrosine kinase inhibitor (TKI) administration, in the absence of systemic chemotherapy, can experience long-lived responses, minimal residual disease negativity, and a good quality of life. To an extent that stopping TKI administration can also be considered. This perspective article represents a proof of concept that nowadays even in elderly/old Ph+ ALL the disease can be cured or kept under prolonged control if adequately managed.