Blinatumomab plus ponatinib for relapsed/refractory Philadelphia chromosome-positive acute lymphoblastic leukemia in adults

We retrospectively examined the results of a new chemo-free approach combining blinatumomab with ponatinib (blina/pona) in 26 relapsed/refractory Philadelphia positive (Ph+) acute lymphoblastic leukemia (ALL) patients. All but one achieved complete morphologic remission, and 23 achieved a complete molecular response. With a median follow-up of 34.4 months, the median overall (OS) and event-free (EFS) survivals were 20 and 15.3 months, respectively. After blina/pona, 8 patients underwent an allotransplant (allo), while among the 18 non-transplanted cases, 15 received ponatinib in maintenance. Fifteen relapse/progressions occurred with a significant difference between allo and non allo cases (12.5% vs 82.3%, p = 0.003). However, OS and EFS were similar between both groups. Finally, blina/pona was well tolerated with eight reversible neurologic events and three cytokine release syndromes. Prospective studies are needed to properly assess the safety, tolerability and efficacy of the combination therapy.

Automated summary

The study retrospectively examined the efficacy of a new chemo-free approach combining blinatumomab with ponatinib in treating Ph+ ALL patients, showing promising results with most patients achieving complete remission. Differences were observed in relapse/progression rates between allo and non allo cases, highlighting the need for further research to confirm the findings. Prospective studies are warranted to evaluate the safety, tolerability, and efficacy of the combination therapy.