A five‐gene signature may associate with central nervous system dissemination in adult acute lymphoblastic leukemia

Sapienza, Maria Rosaria; Chiaretti, Sabina; Cardinali, Deborah; Mazzara, Saveria; Chiarle, Roberto; Foà, Robin; Pileri, Stefano

doi:10.1002/hon.3136

Cited by 1 publication

(2 citation statements)

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“…Although it is reassuring that three patients were salvaged by alternative treatments followed by transplant, a signature predictive of a CNS localization/recurrence is being investigated. 30 The role of p190 and p210 has been widely discussed: p210 cases generally show a slower MRD clearance, but this does ultimately not affect outcome. Although the noninferior outcome is confirmed in our study (not shown), in p210 cases, relapses occurred at later time points.…”

Section: Discussionmentioning

confidence: 99%

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Long-Term Results of the Dasatinib-Blinatumomab Protocol for Adult Philadelphia-Positive ALL

Foà,

Bassan,

Elia

et al. 2024

JCO

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Clinical trials frequently include multiple end points that mature at different times. The initial report, typically based on the primary end point, may be published when key planned coprimary or secondary analyses are not yet available. Clinical trial updates provide an opportunity to disseminate additional results from studies, published in JCO or elsewhere, for which the primary end point has already been reported. We report the long-term results of the frontline trial with dasatinib and blinatumomab in induction/consolidation (GIMEMA LAL2116, D-ALBA) for adult Philadelphia-positive ALL (Ph+ ALL), which enrolled 63 patients of all ages. At a median follow-up of 53 months, disease-free survival, overall survival, and event-free survival are 75.8%, 80.7%, and 74.6%, respectively. No events have occurred among early molecular responders. A significantly worse outcome was recorded for IKZF1 plus patients. Twenty-nine patients—93.1% being in molecular response (ie, complete molecular response or positive nonquantifiable) after dasatinib/blinatumomab—never received chemotherapy/transplant and continued with a tyrosine kinase inhibitor only; 28 patients remain in long-term complete hematologic response (CHR). An allogeneic transplant was carried out in first CHR mainly in patients with persistent minimal residual disease; 83.3% of patients are in continuous CHR. The transplant-related mortality was 12.5% for patients transplanted in first CHR and 13.7% overall. Nine relapses and six deaths have occurred. ABL1 mutations were found in seven cases. The final analysis of the D-ALBA study shows that a chemotherapy-free induction/consolidation regimen on the basis of a targeted strategy (dasatinib) and immunotherapy (blinatumomab) is effective in inducing durable long-term hematologic and molecular responses in adult Ph+ ALL, paving the way for a new era in the management of these patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%