Super-refractory status epilepticus during blinatumomab initiation for B-cell acute lymphoblastic leukemia.
Chethan K RaoSamuel KamoroffJulian ZorrillaMichael JoyceFernando N GalanPublished in: Immunotherapy (2023)
Seizures have been reported as an adverse effect of blinatumomab, a bispecific T-cell engager monoclonal antibody, which is mainly used for the treatment of pediatric relapsed/refractory leukemia. Here, we present the first reported case of super-refractory status epilepticus in an 11-year-old boy with B-cell acute lymphoblastic leukemia (B-ALL) while receiving blinatumomab. Our patient had a complete return to baseline despite enduring encephalopathy, refractory subclinical seizures requiring prolonged therapeutic burst suppression and MRI signal changes. This case demonstrates that super-refractory status epilepticus is a possible neurotoxic adverse effect of blinatumomab treatment, which responds well to conventional protocols for acute refractory seizures.
Keyphrases
- acute lymphoblastic leukemia
- allogeneic hematopoietic stem cell transplantation
- monoclonal antibody
- liver failure
- case report
- bone marrow
- magnetic resonance
- acute respiratory distress syndrome
- contrast enhanced
- extracorporeal membrane oxygenation
- replacement therapy
- early onset
- hepatitis b virus
- respiratory failure