SOHO 2026 Sessions Reveal Key Updates Across Leukemia Populations

The 2026 Society of Hematologic Oncology (SOHO) Annual Meeting shared notable developments, talking points, and clinical trial data across a variety of hematologic malignancies and blood disorders. Among these sessions, researchers and clinicians highlighted findings and analyses that may help shape the management of different leukemia subtypes, including acute lymphoblastic leukemia (ALL), acute myeloid leukemia (AML), and chronic lymphocytic leukemia (CLL).

From studies on investigational tyrosine kinase inhibitors (TKI) to real-world data elucidating adverse effect (AE) incidence across established standards of care, here are some of the key takeaways that emerged from the leukemia poster sessions.

Olverembatinib Combination May Offer New Chemotherapy-Free Option in AML

Combining olverembatinib (HQP1351), a novel third-generation BCR-ABL TKI, with blinatumomab (Blincyto) produced favorable responses among patients with lymphoid blast phase chronic myeloid leukemia (CML-LBP) or Philadelphia chromosome (Ph)–positive B-cell precursor ALL in a phase 1b study (NCT04260022).¹

Among 13 enrolled patients, a complete response (CR) occurred in 90.9% (n = 10/11) of the population, and 66.7% (n = 8/12) experienced a molecular response (MR) 4.0. Minimal residual disease negativity (MRD) at 10^–4 sensitivity was reported in 80% (n = 8/10) of patients.

Regarding safety, 46% (n = 6/13) of patients had grade 3/4 treatment-related AEs (TRAEs) associated with olverembatinib, and 39% (n = 5/13) had grade 3/4 TRAEs associated with blinatumomab. Neutropenia (23.1%) was the most common grade 3/4 TRAE, and investigators observed no instances of grade 3 or higher cytokine release syndrome (CRS), immune effector cell-associated neurotoxicity syndrome (ICANS), or arterial occlusive events.

“This treatment strategy was a successful bridge to CAR-T and transplantation in several patients,” lead study author Elias Jabbour, MD, from the Department of Leukemia at The University of Texas MD Anderson Cancer Center, wrote with coauthors in the poster.¹ “The combination had a manageable safety profile, with no new safety signals.”

How Do Menin Inhibitors Stack Up in AML?

A systematic review and meta-analysis showed significant efficacy with currently approved menin inhibitors in relapsed/refractory NPM1-mutated AML, which included revumenib (Revuforj) and ziftomenib (Komzifti).² However, the current data appeared to support ziftomenib as a next-generation therapeutic backbone in this treatment setting.

Across 4 studies assessing 176 patients, the pooled complete response (CR) and CR with hematologic recovery (CRh) rate was 23.4% (95% CI 13.5%-35.2%) with revumenib vs 21.4% (95% CI, 14.2%-30.2%) with ziftomenib. Additionally, each respective agent yielded an MRD negativity rate of 45.0% (95% CI, 32.1%-58.2%) vs 61.0% (95% CI, 45.1%-74.3%), a 12-month OS rate of 50.0% vs 55.0% (HR, 0.85; 95% CI, 0.61-1.19; P = .34), and a 12-month progression-free survival (PFS) rate of 31.0% vs 36.0% (HR, 0.82; 95% CI, 0.60-1.19; P = .23).

Safety data showed that 43.0% of patients receiving revumenib experienced any-grade QTc prolongation vs 5.0% of those who received ziftomenib; grade 3 or higher events occurred in 23.0% and 1.0% of patients, respectively. In the revumenib and ziftomenib populations, respectively, 5.0% vs 25.0% had any-grade differentiation syndrome, 38.0% vs 36.0% had infections of any grade, and 12.0% vs 9.0% discontinued therapy due to toxicity.

“Both revumenib and ziftomenib achieved comparable CR/CRh rates, while ziftomenib produced deeper molecular responses and minimal clinically significant cardiac toxicity. Differentiation syndrome was more frequent with ziftomenib but manageable,” Mishal Tariq, MBBS, from Rawalpindi Medical University in Rawalpindi, Pakistan, wrote with coauthors in the poster.² “These findings support ziftomenib as a next-generation targeted therapeutic backbone in [relapsed/refractory] NPM1-mutated AML.”

How Safe Are Different BTK Inhibitors in CLL?

Compared with ibrutinib (Imbruvica) and acalabrutinib (Calquence), zanubrutinib (Brukinsa) emerged with the most favorable real-world safety profile among patients with CLL, according to findings from a propensity score-matched analysis.³

The analysis included 1:1 propensity score-matched comparisons for ibrutinib vs zanubrutinib (n = 1622 each), acalabrutinib vs zanubrutinib (n = 1618 each), and acalabrutinib vs ibrutinib (n = 3132 each). When comparing ibrutinib vs zanubrutinib, the latter showed lower rates of death (32.0% vs 11.8%; P <.001), infection (44.1% vs 18.3%; P <.001), heart failure (16.0% vs 5.7%: P = .004), atrial fibrillation (20.5% vs 4.9%; P <.001), ventricular arrhythmia (4.9% vs 1.4%; P <.001), and transaminase elevation (4.7% vs 2.1%; P <.001). For acalabrutinib vs zanubrutinib, the latter showed lower rates of death (16.0% vs 11.9%; P = .001), infection (29.0% vs 18.3%; P <.001), heart failure (8.4% vs 5.6%; P = .004), atrial fibrillation (9.7% vs 4.9%; P <.001), ventricular arrhythmia (2.1% vs 1.3%; P = .101), and transaminase elevation (3.5% vs 2.1%; P = .015).

“Zanubrutinib demonstrated the most favorable real-world safety profile, significantly reducing cardiotoxic, infectious, and hepatic complications compared with ibrutinib and acalabrutinib,” Vishw Patel, MD, from SUNY Update Medical University, wrote with coauthors in the poster.³ “Acalabrutinib remains safer than ibrutinib, which exhibited the highest toxicity burden. Although both next-generation agents are superior to ibrutinib, they are not safety-interchangeable, findings that can help guide treatment selection for patients at high risk for off-target complications.”

References

1. Jabbour E, Baer MR, Hunter AM, et al. Olverembatinib combined with blinatumomab in patients with lymphoid blast phase chronic myeloid leukemia or Philadelphia chromosome-positive B-cell precursor acute lymphoblastic leukemia. Presented at: 2026 Society of Hematologic Oncology (SOHO) Annual Meeting; September 9-12, 2026; Houston, TX. Abstract ALL-589.
2. Tariq M, Junnuthula A, Nawaz Z, et al. Comparative efficacy and safety of FDA-approved menin inhibitors in relapsed/refractory NPM1-mutated acute myeloid leukemia: a systematic review and meta-analysis. Presented at: 2026 Society of Hematologic Oncology (SOHO) Annual Meeting; September 9-12, 2026; Houston, TX. Abstract AML-750.
3. Patel V, Avaiya NS, Patel D, Kanpariya A, Varsadiya K, Avaiya A. Real-world safety comparison of BTK inhibitors in chronic lymphocytic leukemia: a propsensity score-matched analysis of acalabrutinib, ibrutinib, and zanubrutinib. Presented at: 2026 Society of Hematologic Oncology (SOHO) Annual Meeting; September 9-12, 2026; Houston, TX. Abstract CLL-1019.