Dasatinib, prednisone, and blinatumomab combination shows promising outcomes in elderly patients with Ph+ ALL

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Published: 19 Dec 2025
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Dr Anjali Advani - Cleveland Clinic, Cleveland, USA

Dr Advani presents long-term follow-up results from the SWOG 1318 trial, evaluating the combination of dasatinib, prednisone, and blinatumomab in elderly patients with newly diagnosed Philadelphia chromosome-positive (Ph+) acute lymphoblastic leukaemia (ALL).

The study demonstrated impressive outcomes, including high remission rates, with factors such as the number of blinatumomab cycles and the presence of extramedullary disease influencing survival.

Translational studies on chromatin accessibility may also help identify new predictors of overall survival.

The SWOG 1318 study, this is a study that was done in Ph+ ALL and it was for patients that were 65 years of age and older with Philadelphia positive B-cell ALL. In this trial patients received dasatinib and steroids as induction and then received blinatumomab and dasatinib as post-remission treatment, then followed by dasatinib and steroids as maintenance.

So this study has been presented before but this was the longer-term follow-up at a median of about 5.6 years. So we were looking at disease free survival and overall survival at that timepoint and we were also looking to see whether there were also predictors of response and outcomes.

So basically we found that the event free survival and overall survival were approximately 65% which is fairly good, especially for this older patient population. We did see that it looked like patients who were older maybe had a lower response rate during induction and that receiving more cycles of blinatumomab there was a trend towards an improved outcome. Those patients who had extramedullary disease, basically disease outside of the bone marrow, those patients there was a trend towards a slightly worse outcome.

The last part of this study was really looking at some correlative data, translational medicine data, that was done by Cecilia Yeung and [??] at Fred Hutchinson. In this we looked at things like chromatin accessibility to things such as HOXA2 and it did look like there were some trends towards correlations in terms of outcomes. So those will need to be studied in a larger-scale manner.

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