dasatinib + prednisone + blinatumomab

Dasatinib + prednisone + blinatumomab is an investigational combination regimen for Philadelphia chromosome-positive (Ph+) acute lymphoblastic leukemia (ALL), particularly in older patients (age ≥65 years). It involves induction with the tyrosine kinase inhibitor **dasatinib** (140 mg daily) and corticosteroid **prednisone** (60 mg/m²), followed by post-remission therapy with **blinatumomab** (anti-CD19 bispecific T-cell engager, stepped up from 9 μg/day to 28 μg/day) plus reduced-dose dasatinib (70 mg daily), and maintenance with dasatinib and intermittent prednisone. Evaluated in SWOG S1318 phase II trial, it demonstrated high feasibility, complete remission in all 24 newly diagnosed patients (median age 73), 3-year overall survival of 87%, and disease-free survival of 77%, with manageable toxicities including myelosuppression, cytokine release syndrome risks mitigated by steroids, and dose adjustments for pulmonary/cardiac events.[1][2][4]