Third-line therapy outcomes in Ph+ ALL: A retrospective analysis

Results from a retrospective analysis summarizing third-line therapy outcomes in 89 patients aged ≥17 years with Philadelphia chromosome-positive (Ph+) acute lymphoblastic leukemia (ALL) in Salvage 2 who were treated at the MD Anderson Cancer Center between 1992 and 2025 were published in Clinical Lymphoma, Myeloma and Leukemia by Jen et al. Primary outcomes included response and survival. 

Key data: The overall complete remission (CR) rate was 58%, and the 3-year survival rate was 17% across the full cohort. Among 27 patients treated during 2017–2025, the CR rate was 89% vs 45% before 2017. Focus was placed on outcomes since 2017, when combinations incorporating novel agents were introduced into standard-of-care treatment. The 3-year survival rate during 2017–2025 was 52% vs 6% during 2010–2016, and 0% in all prior time frames (p < 0001). The overall induction mortality rate was 12%; induction mortality reduced from 18% prior to 2017 to 0% from 2017 onwards. On multivariate analysis, therapy modality and duration of first remission were independent predictors of CR.  

Key learning: The development and incorporation of targeted therapies and immunotherapies into clinical practice has substantially improved outcomes in patients with Ph+ ALL in Salvage 2, supporting the use of modern combination strategies in this historically high-risk population.