Hematology

Fixed-duration venetoclax–obinutuzumab achieves deeper uMRD than FCR/BR in fit, standard-risk, untreated CLL

CRISTALLO randomized fit, previously untreated CLL patients without del(17p)/TP53 mutations to venetoclax–obinutuzumab versus FCR/BR, with peripheral-blood uMRD at month 15 as primary endpoint. Venetoclax–obinutuzumab achieved higher uMRD <10−4 at month 15 versus FCR/BR (81.3% vs 54.7%; P=0.0004). Deep MRD <10−6 at month 15 was also more frequent with venetoclax–obinutuzumab (65.0% vs 25.6%). More patients had uMRD in both blood and marrow at end of treatment, and fewer progression/death events occurred with venetoclax–obinutuzumab at early follow-up. 1

FLT3 inhibitor maintenance after allo-HCT improves survival in FLT3-ITD AML, with strong real-world signal for sorafenib

This German registry included 523 adults with FLT3-ITD AML in first remission after allo-HCT; 22% received FLT3 inhibitor maintenance, mainly sorafenib or midostaurin. In multivariable analyses, FLT3 inhibitor maintenance improved overall survival, relapse-free survival, non-relapse mortality, and GVHD- and relapse-free survival versus no maintenance. Overall-survival advantages were seen in both MRD-positive and MRD-negative subgroups on univariate analyses. Sorafenib maintenance yielded 5-year overall survival 85% versus 62% and relapse-free survival 84% versus 55% compared with no maintenance. 2

REALiTEC confirms teclistamab activity and known toxicities in heavily pretreated real-world RRMM

REALiTEC retrospectively analyzed 113 RRMM patients treated with teclistamab outside trials across 23 sites in eight countries. Patients were heavily pretreated; most were triple-class refractory, many penta-class refractory, and over one-third previously exposed to anti-BCMA therapy. Overall response rate was 60.2%, with ≥VGPR in 52.2%; median duration of response was 20.3 months. Median progression-free survival was 9.7 months and median overall survival 26.3 months, with longer outcomes among patients achieving ≥VGPR. 3