TY - JOUR
T1 - Real-world outcomes of adult B-cell acute lymphocytic leukemia patients treated with blinatumomab
AU - Badar, Talha
AU - Szabo, Aniko
AU - Advani, Anjali
AU - Wadleigh, Martha
AU - Arslan, Shukaib
AU - Khan, Muhammad Ali
AU - Aldoss, Ibrahim
AU - Siebenaller, Caitlin
AU - Schultz, Elizabeth
AU - Hefazi, Mehrdad
AU - Shallis, Rory M.
AU - Yurkiewicz, Ilana
AU - Podoltsev, Nikolai
AU - Patel, Anand A.
AU - Curran, Emily
AU - Balasubramanian, Suresh
AU - Yang, Jay
AU - Mattison, Ryan J.
AU - Burkart, Madelyn
AU - Dinner, Shira
AU - Liedtke, Michaela
AU - Litzow, Mark R.
AU - Atallah, Ehab
N1 - Publisher Copyright:
© 2020 by The American Society of Hematology
PY - 2020/5/26
Y1 - 2020/5/26
N2 - The availability and use of blinatumomab symbolizes a paradigm shift in the management of B-cell acute lymphoblastic leukemia (ALL). We conducted a retrospective multicenter cohort analysis of 239 ALL patients (227 relapsed refractory [RR], n 5 227; minimal residual disease [MRD], n 5 12) who received blinatumomab outside of clinical trials to evaluate safety and efficacy in the “real-world” setting. The median age of patients at blinatumomab initiation was 48 years (range, 18-85). Sixty-one (26%) patients had $3 prior therapies and 46 (19%) had allogeneic hematopoietic cell transplantation before blinatumomab. The response rate (complete remission/complete remission with incomplete count recovery) in patients with RR disease was 65% (47% MRD2). Among 12 patients who received blinatumomab for MRD, 9 (75%) patients achieved MRD negativity. In patients with RR disease, median relapse-free survival and overall survival (OS) after blinatumomab was 32 months and 12.7 months, respectively. Among patients who received blinatumomab for MRD, median relapse-free survival was not reached (54% MRD2 at 2 years) and OS was 34.7 months. Grade $3 cytokine release syndrome, neurotoxicity, and hepatotoxicity were observed in 3%, 7%, and 10% of patients, respectively. Among patients who achieved complete remission/complete remission with incomplete count recovery, consolidation therapy with allogeneic hematopoietic cell transplantation retained favorable prognostic significance for OS (hazard ratio, 0.54; 95% confidence interval, 0.30-0.97; P 5.04). In this largest “real-world” experience published to date, blinatumomab demonstrated responses comparable to those reported in clinical trials. The optimal sequencing of newer therapies in ALL requires further study.
AB - The availability and use of blinatumomab symbolizes a paradigm shift in the management of B-cell acute lymphoblastic leukemia (ALL). We conducted a retrospective multicenter cohort analysis of 239 ALL patients (227 relapsed refractory [RR], n 5 227; minimal residual disease [MRD], n 5 12) who received blinatumomab outside of clinical trials to evaluate safety and efficacy in the “real-world” setting. The median age of patients at blinatumomab initiation was 48 years (range, 18-85). Sixty-one (26%) patients had $3 prior therapies and 46 (19%) had allogeneic hematopoietic cell transplantation before blinatumomab. The response rate (complete remission/complete remission with incomplete count recovery) in patients with RR disease was 65% (47% MRD2). Among 12 patients who received blinatumomab for MRD, 9 (75%) patients achieved MRD negativity. In patients with RR disease, median relapse-free survival and overall survival (OS) after blinatumomab was 32 months and 12.7 months, respectively. Among patients who received blinatumomab for MRD, median relapse-free survival was not reached (54% MRD2 at 2 years) and OS was 34.7 months. Grade $3 cytokine release syndrome, neurotoxicity, and hepatotoxicity were observed in 3%, 7%, and 10% of patients, respectively. Among patients who achieved complete remission/complete remission with incomplete count recovery, consolidation therapy with allogeneic hematopoietic cell transplantation retained favorable prognostic significance for OS (hazard ratio, 0.54; 95% confidence interval, 0.30-0.97; P 5.04). In this largest “real-world” experience published to date, blinatumomab demonstrated responses comparable to those reported in clinical trials. The optimal sequencing of newer therapies in ALL requires further study.
UR - http://www.scopus.com/inward/record.url?scp=85086878601&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85086878601&partnerID=8YFLogxK
U2 - 10.1182/bloodadvances.2019001381
DO - 10.1182/bloodadvances.2019001381
M3 - Article
C2 - 32453836
AN - SCOPUS:85086878601
SN - 2473-9529
VL - 4
SP - 2308
EP - 2316
JO - Blood Advances
JF - Blood Advances
IS - 10
ER -