Relapsed Philadelphia chromosome‐positive B‐cell acute lymphoblastic leukaemia responds well to a combination of modified hyper‐CVAD, blinatumomab and tyrosine kinase inhibitor

Relapsed Philadelphia chromosome‐positive B‐cell acute lymphoblastic leukaemia responds well to a combination of modified hyper‐CVAD, blinatumomab and tyrosine kinase inhibitor

Abstract Introduction Adults with relapsed or refractory Philadelphia chromosome‐positive B‐cell precursor acute lymphoblastic leukaemia (R/R Ph+ BCP‐ALL) have a dismal outcome. Blinatumomab as a single agent has shown activity in R/R Ph‐ BCP‐ALL, and second or third‐generation tyrosine kinase inhib...

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Main Authors: Gaétan Basile, Jean Galtier, Titouan Cazaubiel, Edouard Forcade, Emilie Klein, Audrey Bidet, Carmen Botella‐Garcia, Clémence Mediavilla, Laurence Clement, Pierre‐Yves Dumas, Arnaud Pigneux, Thibaut Leguay
Format: Article
Language:English
Published: Wiley 2025-02-01
Series:eJHaem
Subjects:
acute leukaemia
ALL
immunotherapy
tyrosine kinases
Online Access:https://doi.org/10.1002/jha2.1064
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Summary:Abstract Introduction Adults with relapsed or refractory Philadelphia chromosome‐positive B‐cell precursor acute lymphoblastic leukaemia (R/R Ph+ BCP‐ALL) have a dismal outcome. Blinatumomab as a single agent has shown activity in R/R Ph‐ BCP‐ALL, and second or third‐generation tyrosine kinase inhibitors (TKIs) can produce high remission rates in Ph+ leukaemias. We aimed to assess the activity of blinatumomab and TKI in combination with intensive chemotherapy in the relapsed or refractory setting. Methods Ten patients with R/R Ph+ BCP‐ALL were treated with the combination of a modified hyper‐CVAD (mHCVAD) regimen (cyclophosphamide, vincristine, adriamycin, dexamethasone), blinatumomab and TKI (mainly ponatinib). Results Complete remission (CR) was achieved in 10/10 patients, with deep molecular responses, and 6/10 were alive in remission after a median follow‐up of 19.4 months. Three major cardiovascular events were noted. Conclusion These preliminary data, suggest that the mHCVAD‐blinatumomab‐TKI (mainly ponatinib) regimen may achieve a high rate of CR with undetectable measurable residual disease in adults with R/R Ph+ BCP‐ALL and could be proposed to such patients, but cardiovascular or infectious complications should be warning, especially in older or frail patients.
ISSN:2688-6146

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