ArticleBlood advances2026
Improved outcomes with TKI maintenance after brexucabtagene autoleucel in Philadelphia chromosome ALL.
Article in Blood advances, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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43 authors.
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Abstract
abstractBrexucabtagene autoleucel (brexu-cel) produces high rates of measurable residual disease-negative (MRD-) complete response (CR) in adult patients with Philadelphia chromosome-positive (Ph+) acute lymphoblastic leukemia (ALL); however, subsequent relapses remain frequent. It is unclear whether maintenance with tyrosine kinase inhibitors (TKIs) can enhance remission durability. We evaluated outcomes among adult patients with relapsed/refractory Ph+ ALL who received commercial brexu-cel and achieved MRD- CR across 19 US institutions. Considering TKI maintenance as a time-varying covariate, we analyzed outcomes based on receipt of subsequent TKI maintenance vs no maintenance. Patients receiving consolidative transplantation or non-TKI maintenance were excluded. Fifty-one patients were included: 20 received TKI maintenance, and 31 received no maintenance. The use of TKI maintenance was associated with a significantly lower 1-year cumulative incidence of relapse (hazard ratio [HR], 0.12; 95% confidence interval [CI], 0.02-0.88; P = .037), which translated into improved progression-free survival (PFS; HR, 0.19; 95% CI, 0.04-0.85; P = .029) and a trend toward improved overall survival (HR, 0.34; 95% CI, 0.07-1.62; P = .18). There was no difference in nonrelapse mortality (HR, 0.83; 95% CI, 0.12-5.87; P = .85). This real-world analysis supports the administration of TKI maintenance in Ph+ ALL after achievement of MRD- CR with brexu-cel as a strategy to improve PFS after chimeric antigen receptor T-cell therapy.
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