{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T14:55:16Z","timestamp":1791903316386,"version":"4.3.4"},"reference-count":32,"publisher":"American Society of Hematology","issue":"19","content-domain":{"domain":["ashpublications.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,10,13]]},"abstract":"<jats:sec>\n                    <jats:title>Abstract<\/jats:title>\n                    <jats:p>We report outcomes of the phase 2 study combining carfilzomib (CFZ) and VXLD (vincristine, dexamethasone, asparaginase, and daunorubicin; CFZ-VXLD) in heavily pretreated, pediatric patients with relapsed\/refractory (R\/R) acute lymphoblastic leukemia (ALL). We investigated whether postinduction complete remission (CR) rates after CFZ-VXLD induction are superior to an external real-world control (EC). Patients aged \u22651 month to &amp;lt;21 years with R\/R ALL received CFZ-VXLD induction, followed by optional consolidation (experimental arm). The EC arm included similar patients receiving real-world, curative-intent regimens at Therapeutic Advances in Childhood Leukemia sites between 2000 and 2023. The primary end point was CR after induction; overall response rate (ORR; CR\/CR with partial\/incomplete hematologic recovery\/CR without platelet recovery) was a secondary end point. Comparative analyses used inverse probability of treatment weighting. Experimental and EC arms included 105 and 140 patients, respectively. CR rates after induction were 14.8% vs 7.8% (odds ratio [OR], 2.04; 95% confidence interval [CI], 0.54-7.66) in patients with B-cell ALL (B-ALL) and 13.6% vs 9.1% (OR, 1.58; 95% CI, 0.47-5.31) in patients with T-cell ALL. There was no statistically significant increase in postinduction CR for the CFZ-VXLD arm vs the EC arm and the study did not meet its primary end point. In patients with B-ALL, ORR was 42.6% vs 26.3%, favoring the CFZ-VXLD arm vs the EC arm. Adverse event rates with CFZ were consistent with previous reports. Overall, the CFZ-VXLD regimen may be an option for some selected pediatric patients with R\/R ALL, and this study highlights that novel treatments for R\/R ALL remain an area of unmet medical need. This trial was registered at www.clinicaltrials.gov as NCT02303821.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1182\/bloodadvances.2025019356","type":"journal-article","created":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T19:45:41Z","timestamp":1780515941000},"page":"6567-6577","update-policy":"https:\/\/doi.org\/10.1182\/blood.2019cm0000","source":"Crossref","is-referenced-by-count":0,"title":["Carfilzomib plus induction chemotherapy for children with relapsed or refractory acute lymphoblastic leukemia"],"prefix":"10.1182","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7976-3654","authenticated-orcid":false,"given":"Franco","family":"Locatelli","sequence":"first","affiliation":[{"name":"1IRCCS Ospedale Pediatrico Bambino Ges\u00f9, Catholic University of the Sacred Heart, Rome, 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Mendes","family":"Lins","sequence":"additional","affiliation":[{"name":"5Department of Pediatric Oncology, Instituto de Medicina Integral Professor Fernando Figueira, Recife, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meng-Yao","family":"Lu","sequence":"additional","affiliation":[{"name":"6National Taiwan University Hospital, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Luisa","family":"Sulis","sequence":"additional","affiliation":[{"name":"7Pediatric Hematologic Malignancies Service, Memorial Sloan Kettering Cancer Center, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8906-5836","authenticated-orcid":false,"given":"Melinda","family":"Pauly","sequence":"additional","affiliation":[{"name":"8Department of Pediatrics, Emory University, Atlanta, GA"},{"name":"9Aflac Cancer and Blood Disorders Center, Children\u2019s Healthcare of Atlanta, Atlanta, 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