Cancer · 2026
Outcome of second-line therapy in adult B-cell acute lymphoblastic leukemia.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
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Kantarjian Hagop, Qiao Wei, Jain Nitin, Jen Wei-Ying, Kugler Eitan, Short Nicholas J, Garris Rebecca, Pierce Sherry, Kebriaei Partow, Wang Sa A, Haddad Fadi, Ravandi Farhad, Huang Xuelin, Jabbour Elias
Аннотация
BACKGROUND AND STUDY AIMS: Historically, adults with B-cell acute lymphoblastic leukemia (ALL) treated with standard intensive chemotherapy in first salvage had a complete response rate of 40% and a 3-year survival rate <10%. The outcome of B-cell ALL on second-line therapy (salvage 1) is changing rapidly with the introduction of novel strategies into both frontline and salvage therapy. The study aim is to define the outcome of adult B-cell ALL on second-line therapy and its predictors in the novel era of ALL therapy.
PATIENTS AND METHODS: A total of 372 adults with B-cell ALL in salvage 1 treated from 2000 until 2024 were analyzed.
RESULTS: The complete remission (CR) rate was 70%; the 3-year survival rate was 30%. By multivariate analysis, the independent adverse predictors for CR were thrombocytopenia, unfavorable karyotype, and older era of therapy; combination of chemotherapy plus blinatumomab/inotuzumab was independently favorable. The independent adverse predictors of survival were older age, unfavorable karyotype, thrombocytopenia, and shorter duration of first CR; again, combination of chemotherapy plus blinatumomab/inotuzumab was independently favorable. Combination of chemotherapy and blinatumomab/inotuzumab was associated with a CR rate of 96% and a 3-year survival rate of 52%.
CONCLUSIONS: This study establishes a modern expectation of outcome of adult B-cell ALL treated in salvage 1. Combination of chemotherapy and blinatumomab/inotuzumab should be a standard of care in adult B-cell ALL in salvage 1.
PATIENTS AND METHODS: A total of 372 adults with B-cell ALL in salvage 1 treated from 2000 until 2024 were analyzed.
RESULTS: The complete remission (CR) rate was 70%; the 3-year survival rate was 30%. By multivariate analysis, the independent adverse predictors for CR were thrombocytopenia, unfavorable karyotype, and older era of therapy; combination of chemotherapy plus blinatumomab/inotuzumab was independently favorable. The independent adverse predictors of survival were older age, unfavorable karyotype, thrombocytopenia, and shorter duration of first CR; again, combination of chemotherapy plus blinatumomab/inotuzumab was independently favorable. Combination of chemotherapy and blinatumomab/inotuzumab was associated with a CR rate of 96% and a 3-year survival rate of 52%.
CONCLUSIONS: This study establishes a modern expectation of outcome of adult B-cell ALL treated in salvage 1. Combination of chemotherapy and blinatumomab/inotuzumab should be a standard of care in adult B-cell ALL in salvage 1.