{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T05:22:04Z","timestamp":1764307324333,"version":"3.46.0"},"reference-count":34,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T00:00:00Z","timestamp":1764288000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>While blinatumomab has demonstrated substantial efficacy in relapsed\/refractory B-cell acute lymphoblastic leukemia (R\/R B-ALL), the therapeutic potential of combining blinatumomab with tyrosine kinase inhibitors (TKIs) and low-dose chemotherapy as frontline induction for newly diagnosed Philadelphia chromosome-positive B-ALL (Ph\u202f+\u202fB-ALL) remains systematically underexplored. This study aims to evaluate the efficacy and safety of blinatumomab in combination with low-dose chemotherapy for induction treatment of newly diagnosed Ph\u202f+\u202fB-ALL.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective analysis was performed on 24 newly diagnosed cases of Ph\u202f+\u202fB-ALL admitted to the Department of Hematology at our institution, between April 2023 and April 2025.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Result<\/jats:title>\n                    <jats:p>\n                      The median age was 51.1\u202fyears in the blinatumomab group (\n                      <jats:italic>n<\/jats:italic>\n                      =\u202f11) and 42.6\u202fyears in the conventional chemotherapy group (\n                      <jats:italic>n<\/jats:italic>\n                      =\u202f13). All 24 patients attained CR after one cycle of induction chemotherapy. The MRD negativity rate showed a trend toward improvement in the blinatumomab group compared with the conventional chemotherapy group (81.8% [9\/11] vs. 46.2% [6\/13]). The median BCR::ABL1 level was 0.10 (range: 0.00\u20130.56) in the blinatumomab group versus 2.13 (range: 0.25\u20139.21) in the conventional chemotherapy group. The mean log reduction in the BCR::ABL1 gene level in the blinatumomab group was 3.09\u202f\u00b1\u202f0.95, which was greater than in the conventional chemotherapy group (1.64\u202f\u00b1\u202f0.83). At a median follow-up of approximately 13.8\u202fmonths, no relapses occurred in the blinatumomab group versus 5 relapses (38.5%) in the conventional group. We documented a significant improvement in 12-month disease-free survival (DFS) rate with the blinatumomab regimen (90.9%) compared to conventional chemotherapy (46.2%). Patients receiving blinatumomab experienced markedly reduced hematologic toxicity, manifested by a shorter duration of neutropenia (2.8\u202f\u00b1\u202f2.4 vs. 6.2\u202f\u00b1\u202f4.4\u202fdays), a lower incidence of bleeding (0% vs. 53.8%), and a lower rate of infections (36.4% vs. 69.2%). This improved safety profile was accompanied by a significantly lower transfusion burden, as evidenced by the consumption of fewer units of platelets (1.61\u202f\u00b1\u202f1.63 vs. 4.33\u202f\u00b1\u202f2.90) and red blood cells (2.14\u202f\u00b1\u202f2.07 vs. 6.15\u202f\u00b1\u202f4.85).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Blinatumomab combined with low-dose chemotherapy and TKIs demonstrated a trend toward improved MRD negativity, lower relapse rates, and reduced hematologic toxicity compared to conventional chemotherapy. These findings support further investigation in larger trials to confirm clinical benefit.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2025.1687242","type":"journal-article","created":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T05:16:49Z","timestamp":1764307009000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Blinatumomab combined with low-dose chemotherapy and tyrosine kinase inhibitors as first-line induction for newly diagnosed Philadelphia chromosome-positive B-cell acute lymphoblastic leukemia: improved efficacy and reduced toxicity"],"prefix":"10.3389","volume":"12","author":[{"given":"Shujuan","family":"Xu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xinxin","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qiaoqiao","family":"Song","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guangyao","family":"Guo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bihong","family":"Cai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zezhong","family":"Yu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huijian","family":"Zheng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ping","family":"Weng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhenshu","family":"Xu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,11,28]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"2357","DOI":"10.1182\/blood-2002-03-0704","article-title":"Outcome 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