期刊
LEUKEMIA & LYMPHOMA
卷 61, 期 11, 页码 2665-2673出版社
TAYLOR & FRANCIS LTD
DOI: 10.1080/10428194.2020.1780583
关键词
Acute lymphoblastic leukemia; minimal residual disease; allogeneic hematopoietic stem cell transplantation; blinatumomab; immuno-oncotherapy
资金
- Amgen Inc.
Minimal residual disease (MRD) is the strongest predictor of relapse in B-cell precursor acute lymphoblastic leukemia (BCP-ALL). In BLAST study (NCT01207388), adults with BCP-ALL in remission with MRD after chemotherapy received blinatumomab, a CD19 BiTE(R)immuno-oncotherapy, 15 mu g/m(2)/day for up to four 6-week cycles (4 weeks continuous infusion, 2 weeks off). Survival was evaluated for 110 patients, including 74 who received HSCT in continuous complete remission. With a median follow-up of 59 center dot 8 months, median survival (months) was 36 center dot 5 (95% CI: 22.0-not reached [NR]). Median survival was NR (29.5-NR) for complete MRD responders (n = 84) and 14.4 (3.8-32.3) for MRD non-responders (n = 23;p = 0.002); after blinatumomab and HSCT, median survival was NR (25.7-NR) (n = 61) and 16.5 (1.1-NR) (n = 10;p = 0.065), respectively. This final analysis suggests complete MRD response during blinatumomab treatment is curative. Post-hoc analysis of study data suggests while post blinatumomab HSCT may be beneficial in appropriate patients, long-term survival without HSCT is also possible.
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