Efficacy and safety of venetoclax combined with tyrosine kinase inhibitors and reduced-dose chemotherapy in 13 cases of minimal residual disease-positive and relapsed/refractory Ph + acute lymphoblastic leukemia
10.3760/cma.j.cn121090-20241202-00521
- VernacularTitle:维奈克拉联合酪氨酸激酶抑制剂及减低剂量化疗治疗微小残留病阳性及难治复发Ph阳性急性淋巴细胞白血病13例疗效及安全性分析
- Author:
Hao AI
1
;
Taotao LIANG
1
;
Qian WANG
1
;
Hongfei WU
1
;
Qingsong YIN
1
Author Information
1. 郑州大学附属肿瘤医院、河南省肿瘤医院血液科，郑州 450008
- Publication Type:Journal Article
- From:
Chinese Journal of Hematology
2025;46(7):655-659
- CountryChina
- Language:Chinese
-
Abstract:
This study sought to evaluate the efficacy and safety of venetoclax (Ven) in combination with tyrosine kinase inhibitors (TKI) and reduced-dose chemotherapy for the treatment of patients with minimal residual disease (MRD) -positive and relapsed/refractory (R/R) Ph-positive acute lymphoblastic leukemia (Ph + ALL). A retrospective analysis was conducted on the clinical data of 13 patients with MRD-positive and relapsed Ph + ALL admitted between July 2015 and February 2024 at the Affiliated Cancer Hospital of Zhengzhou University. The cohort included seven males and six females, with a median age of 50 years (range: 37-71 years). Reinduction therapy consisted of Ven and TKI administration combined with reduced-dose chemotherapy. Among the 13 patients, 10 were MRD-positive, and three had R/R disease. Of the MRD-positive group, nine (90%) achieved complete molecular response (CMR), with a median time to response of 47 days (range: 30-80) ; one patient did not respond. Among the three patients who had R/R, two (66.6%) achieved complete remission, while one patient was nonresponsive. The median overall survival (OS) and relapse-free survival (RFS) time for the entire cohort were 21.5 months and 7 months, respectively. In patients who achieved CMR, the median OS and RFS time were 35 months and 34 months, respectively. Grade ≥3 hematologic adverse events occurred in five patients (38.4%) ; however, hematopoietic function recovered in all cases, and no grade ≥3 infections or organ-related adverse reactions were observed. These findings suggest that Ven combined with TKI and reduced-dose chemotherapy may be an effective and tolerable therapeutic strategy for MRD-positive and R/R Ph + ALL, particularly in significantly improving MRD clearance rates.
