more than 2 years after transplantation (N Saini et al. Blood 2020:136;1786) and one from Japan with
ponatinib post-SCT but with a small number of patients and a short follow-up (S. Nanno et al. Clinical
Lymphoma Myeloma & Leukemia 2020;20;813-819). Altogether the increasing progresses with new
generations TKI, the advent of immunotherapy with bites and conjugated antibodies have led to a new
cocktail combination for newly diagnosed Ph+ ALL patients which should nowadays include a 3rd
generation TKI, namely ponatinib, combined with immunotherapy, blinatumomab being very
promising, and possibly also chemotherapy. The major question being, for the adult population, if
there is a need or not to consolidate with alloSCT. To try to answer this question, we will, with the
GRAALL group, launch a new study combining ponatinib, blinatumomab, chemotherapy and for the
patients entering in CMR, randomize them either to the standard arm with alloSCT or to the study arm
with a combined maintenance therapy and for the patient not entering CMR proceed to alloSCT
whatever the type of donor is, including haplo-identical donors (GRAAPH 2021 study).