Ponatinib/blinatumomab for relapsed Philadelphia chromosome-positive leukemia as a bridge to allogeneic transplantation

Ponatinib/blinatumomab for relapsed Philadelphia chromosome-positive leukemia as a bridge to allogeneic transplantation

We report three cases of ponatinib/blinatumomab (Pona/BLIN) combination therapy as a bridge to allogeneic hematopoietic cell transplantation (allo-HCT) in patients with relapsed/refractory Philadelphia chromosome-positive acute lymphoblastic leukemia (r/r-Ph + ALL) or lymphoid chronic myeloid leukem...

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Main Authors: Yasutaka Sadaga, Daisuke Watanabe, Yuho Najima, Daichi Sadato, Chizuko Hirama, Kana Kato, Kaori Kondo, Chika Kato, Satoshi Sakai, Yasuhiro Kambara, Masashi Shimabukuro, Atsushi Jinguji, Naoki Shingai, Kyoko Haraguchi, Takashi Toya, Hiroaki Shimizu, Takeshi Kobayashi, Yoshiki Okuyama, Yuka Harada, Daisuke Mizuchi, Noriko Doki
Format: Article
Language:English
Published: Taylor & Francis Group 2025-12-01
Series:Hematology
Subjects:
Ponatinib
blinatumomab
Philadelphia chromosome positive acute lymphoblastic leukemia
chronic myeloid leukemia
allogeneic hematopoietic stem cell transplantation
Online Access:https://www.tandfonline.com/doi/10.1080/16078454.2025.2539550
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Summary:We report three cases of ponatinib/blinatumomab (Pona/BLIN) combination therapy as a bridge to allogeneic hematopoietic cell transplantation (allo-HCT) in patients with relapsed/refractory Philadelphia chromosome-positive acute lymphoblastic leukemia (r/r-Ph + ALL) or lymphoid chronic myeloid leukemia blast crisis (CML-BC). Case 1: A 60-year-old man with Ph + ALL achieved molecular complete remission (mCR) with Pona/BLIN after relapse following initial dasatinib-based treatment and subsequently underwent allo-HCT. Case 2: A 39-year-old man with Ph + ALL achieved hematological CR (hCR) with one cycle of inotuzumab ozogamicin and mCR with Pona/BLIN after post-transplant relapse but developed extramedullary relapse with BCR::ABL-negative clone and underwent a second allo-HCT in non-remission. He subsequently developed hematological relapse. Case 3: A 57-year-old woman initially diagnosed with myeloid CML-BC achieved mCR with chemotherapy regimens and dasatinib maintenance but relapsed as lymphoid CML-BC. She achieved hCR with Pona/BLIN and proceeded to allo-HCT. None of the cases developed grade 3 or higher adverse events during treatment. These cases suggest that Pona/BLIN combination therapy is safe and effective as a bridging strategy to allo-HCT, but extramedullary relapse caused by BCR::ABL-negative blasts can occur.
ISSN:1607-8454

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