Highlights from EHA 2025 – Updates in ALL

June 23, 2025

Updates in ALL from the European Hematology Association (EHA) congress 2025

Below are highlights from the EHA 2025 Annual Meeting, summarizing key findings about the safety and effectiveness of new treatment combinations for people with acute lymphoblastic leukemia (ALL).

 

Using treatment schedules for children with ALL in young adults1

What was this study about?

This study looked at whether treatments usually used in children with ALL also work well in young adults (ages 18–40). These treatments are high intensity and include a medicine called asparaginase. Asparaginase removes a protein that leukemia cells need to grow and helps fight the cancer.

Young adults given this ’child-style’ treatment had better results than those who received standard adult treatment. This study followed people for up to 10 years to see how well they continued to do over time.

People with two types of ALL were included in this study, called T-ALL and B-ALL. This study also included people with a subtype of ALL called Ph-like. This type of ALL acts more aggressively and can be harder to treat.

Study overview

  • 295 young adults with ALL were included
  • Average age was 25 years old
  • 25% were younger than 20 years old
  • Body weight: 38% were considered overweight or obese

 

Key results

  • On average people survived for more than 10 years
  • 56% of people were still alive at 10 years
  • 123 people died on the study, of which 75% were disease-related (23 people died of unrelated causes including car accidents etc.)
  • No one with T-ALL had their disease come back after 3 years (relapse)

 

Factors affecting survival

Factors that improved chance of survival

  • Measurable residual disease (MRD):
    • Very sensitive test that can find tiny amounts of cancer in the blood or bone marrow
    • If these tests don’t find any cancer (called MRD negative), people had a better chance of living longer (survival at 10 years MRD negative= 83% vs only 40% for MRD positive people)

 

Factors that reduced chance of survival

  • Body weight: Those who were obese (BMI>40; 27.3% alive after 10 years) did not live as long than those who were within the normal weight range (BMI<30; 63% alive after 10 years)
  • Finishing all treatment: People who finished all their treatment (completed maintenance therapy) had less chance of their cancer coming back (relapsing) than those who did not
  • Subtype: Ph-like ALL had worse survival at 10 years than non-Ph-like ALL (68% alive at 10 years vs 41%, respectively)

 

What does this mean for people with ALL?

This study shows that young adults with ALL can benefit from intensive treatment plans usually given to children. More than half of the people in this study lived beyond 10 years. This study also highlighted that there were certain factors that increased a patient’s chance of living longer on this treatment plan such as finishing all treatment courses and keeping a healthy weight.  

Blinatumomab for the treatment of Ph negative B-ALL2

What was this study about?

This study looked at whether adding a medicine called blinatumomab to standard chemotherapy could help adult patient with B-cell acute lymphoblastic leukemia (B-ALL) live longer. The people in this study had a specific subtype called Ph-negative B-ALL (which means they do not have a genetic change called the Philadelphia chromosome).

The chemotherapy plan used in this trial was adapted from a treatment often used in children and young adults, as it has shown good results in those groups.

Study overview

  • 277 people between the ages of 30 and 54 took part
  • The average age was 42
  • Over half (52%) had high-risk disease, meaning their leukemia had genetic features that are harder to treat

But not all 277 people were included in the final comparison of blinatumomab vs chemotherapy.

Here’s what happened step by step:

  1. Everyone started with two cycles of chemotherapy
    1. After this, 86% had no visible signs of leukemia in their blood or bone marrow (called a complete response)
  2. People who responded well then received an additional phase of treatment called intensification
  3. After this step, people were tested for MRD (measurable residual disease) – this is a very sensitive test that can find tiny amounts of cancer in the blood or bone marrow
  4. 168 people were eligible to move forward at this point. They were randomly assigned to receive either:
    1. blinatumomab plus chemotherapy (66 people), or
    2. chemotherapy alone (65 people)

(The remaining people did not go on to this phase for reasons such as relapse, side effects, or they left the study.)

Key results for people aged 30–54

  • At 3 years, the percentage of people who were still alive was:
    • 92% in the blinatumomab + chemotherapy group
    • 67% in the chemotherapy-only group
  • People aged 30–39 did particularly well:
    • 100% survived at 3 years with blinatumomab
    • 73% survived with chemotherapy alone
  • People with a high-risk subtype called BCR:ABL1-like also benefited:
    • 3-year survival was 100% with blinatumomab
    • Only 45% with chemotherapy alone
  • Body weight (BMI) did not affect survival outcomes

 

Important safety information

The most common side effects in the blinatumomab + chemotherapy group included:

  • Low white blood cells (increased risk of infection)
  • Low platelets which are involved in blood clotting (thrombocytopenia)
  • Anemia (low red blood cells, causing fatigue)
  • Some people also experienced neurological side effects such as confusion or headaches

 

Two people died during treatment due to serious side effects: one due to bleeding in the brain and another due to a heart attack.

What does this study mean for people with ALL?

This study showed that adding blinatumomab to chemotherapy helped more people live longer — even though many had high-risk leukemia. This benefit was seen across different subgroups, including younger adults and people with hard-to-treat genetic features. Because of these results, the combination of blinatumomab should be added to the current standard treatment for adolescents and young adults with Ph-negative B-ALL.

References

  1. Stock, W et al. Presentation at the EHA 2025 Congress, Milan, June, 2025. Abstract s118.
  2. Dinner, S et al. Presentation at the EHA 2025 Congress, Milan, June, 2025. Abstract s110.
Additional data published

Inotuzumab:

  • Stock et al., Abstract S111; Outcomes in Patients With B-Cell Precursor Acute Lymphoblastic Leukemia Receiving Inotuzumab Ozogamicin Stratified by Cumulative Dose (link)
  • Stock et al., Abstract PS1394; Outcomes in Patients With B-Cell Precursor Acute Lymphoblastic Leukemia Receiving Inotuzumab Ozogamicin Stratified by Body Mass Index (link)
  • Marks et al., Abstract PF393; Sinusoidal Obstruction Syndrome and Other Outcomes in Pediatric Patients With Acute Lymphoblastic Leukemia Who Received Inotuzumab Ozogamicin Before Hematopoietic Cell Transplantation (link)
  • Wu et al., Abstract PB2367; Efficacy and Safety of Inotuzumab Ozogamicin in Adult Chinese Patients With Relapsed or Refractory Acute Lymphoblastic Leukemia: Primary Results of an Open-Label, Multi-Center Phase 4 Trial (link)

 

ClonoSEQ

 

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