Hematology

Dasatinib adds toxicity without benefit to intensive chemotherapy in CBF-AML

Adults with CBF-AML received standard 3+7 plus high-dose cytarabine with or without dasatinib during induction, consolidation, and 12 months of maintenance. Event-free survival was similar between arms (HR 0.92; 95% CI 0.63-1.33; p=0.66), with no advantage in overall or relapse-free survival. Subgroup analyses by age, CBF subtype, and KIT mutation status also showed no event-free survival benefit with dasatinib. Serious adverse events were higher with dasatinib (64%) than standard therapy (36%), indicating substantially increased toxicity. 1

MRD-guided ibrutinib–venetoclax yields deeper responses than FCR in intermediate-risk CLL

Fit, previously untreated adults with intermediate-risk CLL without TP53 alteration were randomized to MRD-guided fixed-duration ibrutinib–venetoclax or six cycles of FCR. At 27 months, bone marrow uMRD4 was higher with ibrutinib–venetoclax (37% vs 13%), but missing MRD data precluded confirmatory primary analysis. Best combined deep MRD (BM uMRD4 plus PB uMRD5) favored ibrutinib–venetoclax (47% vs 19%; p=0.009). With 43 months’ median follow-up, progression-free survival was longer with ibrutinib–venetoclax (HR 0.35; 95% CI 0.16-0.80; p=0.012). 2

Thiotepa-ASCT associated with superior survival versus CAR-T in secondary CNS LBCL

An international cohort of 1,139 patients with secondary CNS large B-cell lymphoma was analyzed for progression-free survival, overall survival, and relapse patterns. Two-year PFS was 40.4% for de novo disease, 43.9% for CNS-isolated relapse, and only 16.2% for synchronous CNS and systemic relapse. CNS-isolated relapse showed low systemic recurrence (24‑month cumulative incidence 6%), supporting primary CNS lymphoma–type systemic strategies. Thiotepa-based ASCT independently improved PFS and OS in de novo and CNS-isolated relapse in 6‑month landmark multivariable analysis. 3