Outcomes for Australian children with relapsed/refractory acute lymphoblastic leukaemia treated with blinatumomab.
Rosemary SuttonLuciano Dalla PozzaSeong Lin KhawChris FraserTom ReveszJanis ChamberlainRichard MitchellToby N TrahairCaroline M BatemanNicola C VennTamara LawErika OngSusan L HeatleyBarbara J McClureClaus MeyerRolf MarschalekMichelle J HendersonSiobhan CrossDeborah L WhiteRishi Sury KotechaPublished in: Pediatric blood & cancer (2021)
We report on the Australian experience of blinatumomab for treatment of 24 children with relapsed/refractory precursor B-cell acute lymphoblastic leukaemia (B-ALL) and high-risk genetics, resulting in a minimal residual disease (MRD) response rate of 58%, 2-year progression-free survival (PFS) of 39% and 2-year overall survival of 63%. In total, 83% (n = 20/24) proceeded to haematopoietic stem cell transplant, directly after blinatumomab (n = 12) or following additional salvage therapy (n = 8). Four patients successfully received CD19-directed chimeric antigen receptor T-cell therapy despite prior blinatumomab exposure. Inferior 2-year PFS was associated with MRD positivity (20%, n = 15) and in KMT2A-rearranged infants (15%, n = 9). Our findings highlight that not all children with relapsed/refractory B-ALL respond to blinatumomab and factors such as blast genotype may affect prognosis.
Keyphrases
- acute lymphoblastic leukemia
- cell therapy
- free survival
- stem cells
- young adults
- liver failure
- newly diagnosed
- end stage renal disease
- acute myeloid leukemia
- ejection fraction
- respiratory failure
- diffuse large b cell lymphoma
- hodgkin lymphoma
- prognostic factors
- aortic dissection
- adipose tissue
- metabolic syndrome
- combination therapy
- nk cells