Frontline therapies for adult patients with newly diagnosed Philadelphia chromosome-negative B-cell acute lymphoblastic leukemia: a systematic literature review
Systematic review shows blinatumomab improves survival in adult Philadelphia-negative B-cell acute lymphoblastic leukemia, highlighting the benefit of targeted frontline consolidation.
Key Points
To evaluate the clinical efficacy and safety of frontline pharmacologic therapies in adult patients with newly diagnosed Philadelphia chromosome-negative B-cell acute lymphoblastic leukemia.
Systematically reviewed 96 studies (43 interventional and 53 observational) published between 2012 and 2026.
Assessed frontline treatment outcomes across conventional chemotherapy regimens and targeted pharmacotherapies, including blinatumomab, inotuzumab, and rituximab.
Standard chemotherapy was associated with relapse within 3 years in nearly half of patients and 3-year overall survival rates between 49% and 69%.
Addition of blinatumomab to frontline consolidation in minimal residual disease-negative patients reduced the risk of death by 59% compared with chemotherapy alone (HR 0.41).
Single-arm studies of blinatumomab in minimal residual disease-positive first complete remission achieved a median overall survival of 41.2 months, while inotuzumab showed frontline promise in older adults and rituximab results remained inconclusive.