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Table 4 Possible treatments for adult ALL patients by Ph-positivity, age, and MRD-positivity

From: Allogeneic hematopoietic stem cell transplantation in adult acute lymphoblastic leukemia: potential benefit of medium-dose etoposide conditioning

Ph Age (years) Induction therapy MRD Allo HSCT
<45 Pediatric-inspired Chemotherapy + Allo HSCT with medium-dose ETP + CY + TBI in CR1/2 (Haplo HSCT with MAC in the case of lacking an HLA-matched donor in CR1)
     No HSCT
  45–50 Conventional chemotherapy   Allo HSCT with medium-dose ETP + CY + TBI in CR1/2 (Haplo HSCT with MAC in the case of lacking an HLA-matched donor in CR1)
  50 Conventional chemotherapy Allo HSCT with RIC in CR1 (Haplo HSCT with RIC in the case of lacking an HLA- matched donor in CR1)
+ <45 Conventional or pediatric-inspired chemotherapy + TKI   Allo HSCT with medium-dose ETP + CY + TBI in CR1 (Haplo HSCT with MAC in the case of lacking an HLA-matched donor in CR1)
  45–50 Conventional chemotherapy + TKI   Allo HSCT with medium-dose ETP + CY + TBI in CR1/2 (Haplo HSCT with MAC in the case of lacking an HLA-matched donor in CR1)
  50 Conventional chemotherapy + TKI Allo HSCT with RIC in CR1 (Haplo HSCT with RIC in the case of lacking an HLA-matched donor in CR1)
  1. ALL acute lymphoblastic leukemia, Ph Philadelphia chromosome, MRD minimal residual disease, Allo allogeneic, ETP etoposide, CY cyclophosphamide, TBI total body irradiation, CR complete remission, HLA human leukocyte antigen, Haplo HSCT HLA-haploidentical hematopoietic stem cell transplantation, MAC myeloablative conditioning, RIC reduced-intensity conditioning, TKI tyrosine kinase inhibitor