SOHO 2026 | How does TKI discontinuation impact patients with Ph+ ALL treated with blinatumomab and ponatinib?
Amin Azem, MD, Moffitt Cancer Center, Tampa, FL, discusses outcomes after stopping tyrosine kinase inhibitor (TKI) therapy in patients with Philadelphia chromosome-positive (Ph+) acute lymphoblastic leukemia (ALL) previously treated with blinatumomab and ponatinib. Dr Azem notes this was a high-risk cohort of 31 patients, with a median white blood cell count of 70, and explains that TKI discontinuation was only considered after patients achieved two years of sustained complete molecular response. This interview took place at the 14th Annual Meeting of the Society of Hematologic Oncology (SOHO 2026) in Houston, TX.
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Transcript
So basically, Dr. Abigail Houghton yesterday presented the oral abstract on our work. And what we basically did is we looked back in our database and we were able to identify 31 patients. I will say that, you know, that it is not a low-risk group, actually. Specifically, looking at the white blood cell count, our median white blood cell count was 70. And this has been previously noted to be a high risk for relapse...
So basically, Dr. Abigail Houghton yesterday presented the oral abstract on our work. And what we basically did is we looked back in our database and we were able to identify 31 patients. I will say that, you know, that it is not a low-risk group, actually. Specifically, looking at the white blood cell count, our median white blood cell count was 70. And this has been previously noted to be a high risk for relapse. We had 25% of these patients harboring an Ikaros alteration. Additionally, about 50% of these patients were in the relapsed refractory setting. One-third were in the third line plus. And our patients had a median of three cycles of blinatumomab for treatment. So I will say our institutional practice has been that we would induce patients with a TKI-based attenuated chemotherapy, attenuated regimen, and then move to the blinatumomab-ponatinib phase, and then we would continue maintenance ponatinib. And then after patients have achieved complete molecular response for two years, then we would discuss TKI discontinuation.
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