Targeting relapsed/refractory and MRD + Ph + ALL: olverembatinib-venetoclax bridging enhances allo-HSCT outcome

Olverembatinib is a novel third-generation TKI available in mainland China. However, there are only a few published clinical reports. In this study, we aimed to investigate the efficacy and safety of an olverembatinib-venetoclax regimen before bridging to HSCT in adult Ph/BCR-ABL1 + ALL patients with refractory/relapsed disease (n = 2) or persistent minimal residual disease (MRD) (n = 15). Seventeen Ph + ALL patients who were admitted to our center between February 2022 and January 2023 were enrolled. Four patients harbored a T315I mutation. In all, 100% achieved hematologic complete remission, and 70.6% achieved complete molecular remission. With a median follow-up of 856-day post-HSCT, the 2-year overall survival and relapsed free survival rates was 88.2 ± 7.8% and 79.4 ± 10.9%, respectively. The findings of this study suggest that in Ph + ALL patients with disease recurrence and persistent MRD positivity, olverembatinib-venetoclax regimen showed a high molecular response rate and was well-tolerated in MRD clearance bridged to allo-HSCT.