The efficacy of bortezomib during induction therapy in patients with high-risk acute lymphoblastic leukemia

Introduction: Acute lymphoblastic leukemia (ALL) is characterized by the uncontrolled proliferation of lymphoid precursor cells, most from the B phenotype, which is the result of various cytogenetic mutations and alterations involved in cell division and survival. Objective: To evaluate the efficacy...

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Main Authors: Camila Terreros-Palacios, Daniela Pérez-Sámano, Adán G. Gallardo-Rodríguez, Irma Olarte-Carrillo, Carlos Martínez-Murillo, Gilberto I. Barranco-Lampon, Christian Ramos-Peñafiel
Format: Article
Language:English
Published: Permanyer 2025-07-01
Series:Revista Médica del Hospital General de México
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Online Access:https://www.hospitalgeneral.mx/frame_eng.php?id=260
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author Camila Terreros-Palacios
Daniela Pérez-Sámano
Adán G. Gallardo-Rodríguez
Irma Olarte-Carrillo
Carlos Martínez-Murillo
Gilberto I. Barranco-Lampon
Christian Ramos-Peñafiel
author_facet Camila Terreros-Palacios
Daniela Pérez-Sámano
Adán G. Gallardo-Rodríguez
Irma Olarte-Carrillo
Carlos Martínez-Murillo
Gilberto I. Barranco-Lampon
Christian Ramos-Peñafiel
author_sort Camila Terreros-Palacios
collection DOAJ
description Introduction: Acute lymphoblastic leukemia (ALL) is characterized by the uncontrolled proliferation of lymphoid precursor cells, most from the B phenotype, which is the result of various cytogenetic mutations and alterations involved in cell division and survival. Objective: To evaluate the efficacy of bortezomib in patients with ALL through the measurable residual disease (MRD) outcome at 6 weeks (day +45) and response to induction therapy with chemotherapy in combination with a first-generation proteasome inhibitor. Material and methods: This was cross-sectional, observational, retrospective, and analytical study based on clinical records of patients diagnosed with ALL who received induction therapy plus bortezomib, from January 1, 2019, to May 31, 2024, and comparing it to a historic group. Results: Twenty patients were included, 60% (n = 12) of whom were male, with an average age of 26 years (range 18-61 years). All cases corresponded to the B phenotype, 85% were negative for BCR: ABL1, without central nervous system infiltration (CNS). After treatment initiation, the most common adverse event was anemia and thrombocytopenia (GIII-GIV) and 30% experienced grade I-II peripheral neuropathy. When compared to the historical record, the odds ratio (OR) to evaluate the treatment response with early response variables, there was no difference (confidence interval [CI] = 0.173-1.630, p = 0.206). In overall survival, there were no statistically significant differences when compared with the historical cohort, OR of 1.538 (CI = 0.502-4.748, p = 0.319). Conclusion: The addition of bortezomib to the induction chemotherapy did not show a benefit in the percentage of remissions or the proportion of MRD. It is important to continue exploring new options that can be added to this high-risk group of patients to reduce refractoriness and the proportion of early relapses.
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spelling doaj-art-90104015d34c440694ec0a1b2e92e8aa2025-08-20T03:56:08ZengPermanyerRevista Médica del Hospital General de México0185-10632025-07-01883The efficacy of bortezomib during induction therapy in patients with high-risk acute lymphoblastic leukemiaCamila Terreros-Palacios0Daniela Pérez-Sámano1Adán G. Gallardo-Rodríguez2Irma Olarte-Carrillo3Carlos Martínez-Murillo4Gilberto I. Barranco-Lampon5Christian Ramos-Peñafiel6Department of Hematology. MexicoDepartment of Hematology. MexicoDepartment of Hematology, Hospital General de México Dr. Eduardo Liceaga, Mexico City, MexicoMolecular Biology Laboratory, Department of Hematology, Hospital General de México Dr. Eduardo Liceaga, Mexico City, MexicoDepartment of Hematology, Hospital General de México Dr. Eduardo Liceaga, Mexico City, MexicoHematology Service, Hospital General de México “Dr. Eduardo Liceaga”, Mexico City, MexicoDepartment of Hematology, Hospital General de México Dr. Eduardo Liceaga, Secretaría de Salud, Mexico City, MexicoIntroduction: Acute lymphoblastic leukemia (ALL) is characterized by the uncontrolled proliferation of lymphoid precursor cells, most from the B phenotype, which is the result of various cytogenetic mutations and alterations involved in cell division and survival. Objective: To evaluate the efficacy of bortezomib in patients with ALL through the measurable residual disease (MRD) outcome at 6 weeks (day +45) and response to induction therapy with chemotherapy in combination with a first-generation proteasome inhibitor. Material and methods: This was cross-sectional, observational, retrospective, and analytical study based on clinical records of patients diagnosed with ALL who received induction therapy plus bortezomib, from January 1, 2019, to May 31, 2024, and comparing it to a historic group. Results: Twenty patients were included, 60% (n = 12) of whom were male, with an average age of 26 years (range 18-61 years). All cases corresponded to the B phenotype, 85% were negative for BCR: ABL1, without central nervous system infiltration (CNS). After treatment initiation, the most common adverse event was anemia and thrombocytopenia (GIII-GIV) and 30% experienced grade I-II peripheral neuropathy. When compared to the historical record, the odds ratio (OR) to evaluate the treatment response with early response variables, there was no difference (confidence interval [CI] = 0.173-1.630, p = 0.206). In overall survival, there were no statistically significant differences when compared with the historical cohort, OR of 1.538 (CI = 0.502-4.748, p = 0.319). Conclusion: The addition of bortezomib to the induction chemotherapy did not show a benefit in the percentage of remissions or the proportion of MRD. It is important to continue exploring new options that can be added to this high-risk group of patients to reduce refractoriness and the proportion of early relapses. https://www.hospitalgeneral.mx/frame_eng.php?id=260Acute lymphoblastic leukemia. Bortezomib. Measurable residual disease. Complete remission. Overall survival.
spellingShingle Camila Terreros-Palacios
Daniela Pérez-Sámano
Adán G. Gallardo-Rodríguez
Irma Olarte-Carrillo
Carlos Martínez-Murillo
Gilberto I. Barranco-Lampon
Christian Ramos-Peñafiel
The efficacy of bortezomib during induction therapy in patients with high-risk acute lymphoblastic leukemia
Revista Médica del Hospital General de México
Acute lymphoblastic leukemia. Bortezomib. Measurable residual disease. Complete remission. Overall survival.
title The efficacy of bortezomib during induction therapy in patients with high-risk acute lymphoblastic leukemia
title_full The efficacy of bortezomib during induction therapy in patients with high-risk acute lymphoblastic leukemia
title_fullStr The efficacy of bortezomib during induction therapy in patients with high-risk acute lymphoblastic leukemia
title_full_unstemmed The efficacy of bortezomib during induction therapy in patients with high-risk acute lymphoblastic leukemia
title_short The efficacy of bortezomib during induction therapy in patients with high-risk acute lymphoblastic leukemia
title_sort efficacy of bortezomib during induction therapy in patients with high risk acute lymphoblastic leukemia
topic Acute lymphoblastic leukemia. Bortezomib. Measurable residual disease. Complete remission. Overall survival.
url https://www.hospitalgeneral.mx/frame_eng.php?id=260
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