Blinatumomab following haematopoietic stem cell transplantation - a novel approach for the treatment of acute lymphoblastic leukaemia in infants

Br J Haematol. 2021 Jul;194(1):174-178. doi: 10.1111/bjh.17466. Epub 2021 Apr 11.

Abstract

Blinatumomab with subsequent haematopoietic stem cell transplantation was applied in 13 infants with acute lymphoblastic leukaemia (ALL). Eight patients were treated in first remission due to slow clearance of minimal residual disease (MRD); one for MRD-reappearance after long MRD negativity, one for primary refractory disease and three during relapse treatment. In slow MRD responders, complete MRD response was achieved prior to transplantation, with an 18-month event-free survival of 75%. In contrast, only one of five patients with relapsed/refractory ALL is still in complete remission. These data provide a basis for future studies of immunotherapy in very high-risk infant ALL.

Keywords: acute lymphoblastic leukaemia; blinatumomab; haematopoietic stem cell transplantation; infants; minimal residual disease.

MeSH terms

  • Antibodies, Bispecific / therapeutic use*
  • Antineoplastic Agents, Immunological / therapeutic use*
  • Child, Preschool
  • Disease-Free Survival
  • Female
  • Hematopoietic Stem Cell Transplantation*
  • Histone-Lysine N-Methyltransferase / analysis
  • Humans
  • Infant
  • Kaplan-Meier Estimate
  • Male
  • Myeloid-Lymphoid Leukemia Protein / analysis
  • Neoplasm, Residual
  • Precursor B-Cell Lymphoblastic Leukemia-Lymphoma / drug therapy*
  • Precursor B-Cell Lymphoblastic Leukemia-Lymphoma / genetics
  • Precursor B-Cell Lymphoblastic Leukemia-Lymphoma / pathology
  • Recurrence
  • Salvage Therapy*

Substances

  • Antibodies, Bispecific
  • Antineoplastic Agents, Immunological
  • KMT2A protein, human
  • Myeloid-Lymphoid Leukemia Protein
  • blinatumomab
  • Histone-Lysine N-Methyltransferase