达沙替尼
医学
Blinatumoab公司
强的松
微小残留病
内科学
维持疗法
肿瘤科
化疗
白血病
淋巴细胞白血病
伊马替尼
髓系白血病
作者
Anjali S. Advani,Anna Moseley,Kristen M. O’Dwyer,Brent L. Wood,Jae H. Park,Matthew J. Wieduwilt,Deepa Jeyakumar,George Yaghmour,Ehab Atallah,Aaron T. Gerds,Susan O’Brien,Jane L. Liesveld,Megan Othus,Mark R. Litzow,Richard Stone,Elad Sharon,Harry P. Erba
出处
期刊:Blood Advances
[American Society of Hematology]
日期:2023-03-31
卷期号:7 (7): 1279-1285
被引量:13
标识
DOI:10.1182/bloodadvances.2022008216
摘要
Novel treatment strategies are needed for the treatment of Philadelphia chromosome-positive (Ph+) acute lymphoblastic leukemia (ALL) in older patients. This trial evaluated the feasibility and outcomes with the anti-CD19 bispecific T-cell-engaging antibody, blinatumomab, in combination with dasatinib and steroids. Patients 65 years of age or older with Ph+ or Ph-like ALL (with dasatinib-sensitive fusions/mutations) were eligible and could be newly diagnosed or relapsed/refractory. Induction therapy consisted of dasatinib/prednisone. Patients not achieving response by day 56 proceeded to blinatumomab reinduction therapy. Patients achieving response with induction or reinduction therapy proceeded to blinatumomab/dasatinib postremission therapy for 3 cycles followed by dasatinib/prednisone maintenance. All patients received central nervous system prophylaxis with intrathecal methotrexate for a total of 8 doses. Response was assessed at days 28, 56, and 84 and at additional time points based on response parameters. Measurable residual disease was assessed centrally by 8-color flow cytometry at day 28. A total of 24 eligible patients with newly diagnosed Ph+ ALL were enrolled with a median age of 73 years (range, 65-87 years). This combination was safe and feasible. With a median of 2.7 years of follow-up, 3-year overall survival and disease-free survival were 87% (95% confidence interval [CI], 64-96) and 77% (95% CI, 54-90), respectively. Although longer follow-up is needed, these results are encouraging, and future trials are building on this backbone regimen. This trial was registered at www.clinicaltrials.gov as #NCT02143414.
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