Towards Precision Therapy: A Systematic Review and Meta-Analysis of Targeted Therapy Effectiveness and Safety in Philadelphia Chromosome–Negative Acute Lymphoblastic Leukemia

  • Dewa Ngakan Nyoman Karyana Mataram University, Nusa Tenggara Barat, Indonesia
  • Fadhilla Resendryana Esthya Mataram University, Nusa Tenggara Barat, Indonesia
  • I Nyoman Dwi Suputra Diarsa Mataram University, Nusa Tenggara Barat, Indonesia
DOI: https://doi.org/10.54250/ijls.v8i02.306
Keywords: Acute Lymphoblastic Leukemia Non-Ph, Meta-analysis, Pediatric, Targeted therapy

Abstract

Acute lymphoblastic leukemia (ALL) non-Philadelphia chromosome–positive (non-Ph+) is a major subtype of leukemia with high relapse rates and significant toxicity from conventional chemotherapy. This study evaluated the efficacy and safety of targeted therapy versus chemotherapy in non-Ph+ ALL. This systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020. Five databases were searched for randomized controlled trials (RCTs) comparing both interventions, with outcomes including overall survival (OS), event-free survival (EFS), disease-free survival (DFS), minimal residual disease (MRD), and grade ≥3 adverse events (AEs). Risk of bias was assessed using the Cochrane Risk of Bias 2.0 tool, and pooled estimates were calculated using hazard ratios (HRs) and risk ratios (RRs). Six RCTs from 7,154 records were included. Targeted therapy significantly improved OS (HR 0.59; 95% CI 0.42–0.84) and DFS (HR 0.73; 95% CI 0.55–0.96), with a non-significant trend in EFS (RR 0.69; 95% CI 0.48–1.01). MRD negativity increased after sensitivity analysis (RR 1.85; 95% CI 1.44–2.37), while severe adverse events were reduced (RR 0.88; 95% CI 0.80–0.97). Overall, targeted therapy is associated with improved survival with an acceptable safety profile in non-Ph+ ALL

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Author Biographies

Dewa Ngakan Nyoman Karyana, Mataram University, Nusa Tenggara Barat, Indonesia

Department of Medicine, Mataram University

Fadhilla Resendryana Esthya, Mataram University, Nusa Tenggara Barat, Indonesia

Department of Medicine, Mataram University

I Nyoman Dwi Suputra Diarsa, Mataram University, Nusa Tenggara Barat, Indonesia

Department of Medicine, Mataram University

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Published
2026-09-30
How to Cite
Karyana, D. N. N., Esthya, F. R., & Dwi Suputra Diarsa, I. N. (2026). Towards Precision Therapy: A Systematic Review and Meta-Analysis of Targeted Therapy Effectiveness and Safety in Philadelphia Chromosome–Negative Acute Lymphoblastic Leukemia. Indonesian Journal of Life Sciences, 8(02), 1-16. https://doi.org/10.54250/ijls.v8i02.306
Issue
2026: IJLS Vol 08 No.02
Section
Pharmaceutical Science and Pharmacology

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